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Old -Time  Makers  of  Medicine 


BY  THE   SAME  AUTHOR 


FORDHAM  UNIVERSITY  PRESS  SERIES 


MAKERS  OF  MODERN  MEDICINE 
Lives  of  the  men  to  whom  nineteenth  century  medical  science 

1 910.     $2.00  net. 


owes  most.     Second  Edition.     New  York, 


THE  POPES  AND  SCIENCE 
The  story  of  Papal  patronage  of  the  sciences  and  especially 
medicine.     45th  thousand.      New  York,  1911.       $2.00  net. 

MAKERS  OF  ELECTRICITY 

Lives  of  the  men  to  whom  important  advances  in  electricity 
are  due.  In  collaboration  with  Brother  Potamian,  F.  S.C., 
Sc.D.  (London),  Professor  of  Physics  at  Manhattan  College. 
New  York,  1909.  $2.00  net. 

EDUCATION,  HOW  OLD  THE  NEW 

Addresses  in  the  history  of  education  on  various  occasions. 
3rd  thousand.      New  York,  1911.  $2.00  net. 

IN  PREPARATION 

MAKERS  OF  ASTRONOMY 
PROBLEMS  OLD  AND  NEW  IN  EDUCATION 


THE  THIRTEENTH  GREATEST  OF  CENTURIES 

Georgetown  University  edition.  5th  thousand.  116  illustra- 
tions, nearly  600  pages.  Catholic  Summer  School  Press,  New 
York,  191 1.  Postpaid,  $3.50. 

THE  DOLPHIN  PRESS  SERIES 

CATHOLIC  CHURCHMEN  IN  SCIENCE 

First  and  second  series,  each  $1.00  net. 

IN  COLLABORATION 
ESSAYS  IN  PASTORAL  MEDICINE 

o'MALLEY    AND    WALSH 

A  manual  of  information  on  medical  subjects  for  the  clergy, 
religious  superiors,  superintendents  of  hospitals,  nurses  and  charity 
workers.      Longmans,  New  York,  1911.  $2.50  net. 


I 


Old-Time 


Makers  of  Medicine 


j 


THE  STORY  OF  THE  STUDENTS  AND  TEACHERS 

OF  THE  SCIENCES  RELATED  TO  MEDICINE 

DURING  THE  MIDDLE  AGES 


BY 


Vn/3 


James  J.  Walsh,  K.C.St.G.,  M.D. 

Ph.D.,  LL.D.,  Litt.D.,  Sc.D. 

DEAN  AND  PROFESSOR  OF  NERVOUS  DISEASES   AND   OF  THE  HISTORY   OF  MEDICINE  AT 

FORDHAM  UNIVERSITY  SCHOOL  OF  MEDICINE;    PROFESSOR  OF  PHYSIOLOGICAL 

PSYCHOLOGY  AT   THE   CATHEDRAL   COLLEGE,   NEW  YORK 


NEW   YORK 

FORDHAM  UNIVERSITY  PRESS 
1911 


Copyright  191  i 
JAMES  J.  WALSH 


fiW/ 


----- 


1^8170 


THE    QUINN    &    BODEN    CO.    PRESS 
RAHWAY,    N.  J. 


Co 

REVEREND  DANIEL  J.  QUINN,  S.J. 

The  historical  material  here  presented  was  gathered 
for  my  classes  at  Fordham  University  School  of  Medi- 
cine during  your  term  as  president  of  the  University. 
It  seems  only  fitting  then,  that  when  put  into  more 
permanent  form  it  should  appear  under  the  patrpnage 
of  your  name  and  tell  of  my  cordial  appreciation  of 
more  than  a  quarter  of  a  century  of  valued  friendship. 


"  When  we  have  thoroughly  mastered  contem- 
porary science  it  is  time  to  turn  to  past  science; 
nothing  fortifies  the  judgment  more  than  this  com- 
parative study;  impartiality  of  mind  is  developed 
thereby,  the  uncertainties  of  any  system  become 
manifest.  The  authority  of  facts  is  there  confirmed, 
and  we  discover  in  the  whole  picture  a  philosophic 
teaching  which  is  in  itself  a  lesson ;  in  other  words, 
we  learn  to  know,  to  understand,  and  to  judge." 
— Littre:  (Euvres  d'Hippocrate,  T.  I,  p.  477. 

a  There  is  not  a  single  development,  even  the  most 
advanced  of  contemporary  medicine,  which  is  not  to 
be  found  in  embryo  in  the  medicine  of  the  olden 
time." — Littre:  Introduction  to  the  Works  of  Hip- 
pocrates. 

"  How  true  it  is  that  in  reading  this  history  one 
finds  modern  discoveries  that  are  anything  but  dis- 
coveries, unless  one  supposes  that  they  have  been 
made  twice." — Dujardin:  Histoire  de  la  Chirurgie, 
Paris,  1774  (quoted  by  Gurlt  on  the  post  title-page 
of  his  GeschicMe  der  Chirurgie,  Berlin,  1898). 


PREFACE 

The  material  for  this  book  was  gathered  partly 
for  lectures  on  the  history  of  medicine  at  Fordham 
University  School  of  Medicine,  and  partly  for 
articles  on  a  number  of  subjects  in  the  Catholic  En- 
cyclopedia. Some  of  it  was  developed  for  a  series 
of  addresses  at  commencements  of  medical  schools 
and  before  medical  societies,fon  the  general  topic 
how  old  the  new  is  in  surgery,  medicine,  dentistry, 
and  pharmacy.!  /The  information  thus  presented 
aroused  so  much  interest,  the  accomplishments  of 
the  physicians  and  surgeons  of  a  period  that  is  usu- 
ally thought  quite  sterile  in  medical  science  proved, 
indeed,  so  astonishing,  that  I  was  tempted  to  con- 
nect the  details  for  a  volume  in  the  Fordham  Uni- 
versity Press  series.  There  is  no  pretence  to  any 
original  investigation  in  the  history  of  medicine,  nor 
to  any  extended  consultation  of  original  documents. 
I  have  had  most  of  the  great  books  that  are  men- 
tioned in  the  course  of  this  volume  in  my  hands,  and 
have  given  as  much  time  to  the  study  of  them  as 
could  be  afforded  in  the  midst  of  a  rather  busy  life, 
but  I  owe  my  information  mainly  to  the  distin- 
guished German  and  French  scholars  who  have  in 
recent  years  made  deep  and  serious  studies  of  these 
Old  Makers  of  Medicine,  and  I  have  made  my  ac- 
knowledgments to  them  in  the  text  as  opportunity 
presented  itself. 

There  is  just  one  feature  of  the  book  that  may 


vi  PREFACE 

commend  it  to  present-day  readers,  and  that  is  that 
jour  medieval  medical  colleagues,  when  medicine  em- 
braced most  of  science,  faced  the  problems  of  medi- 
cine and  surgery  and  the  allied  sciences  that  are 
now  interesting  us,  in  very  much  the  same  temper 
of  mind  as  we  do,  and  very  often  anticipated  our 
solutions  of  them — much  oftener,  indeed,  than  most 
of  us,  unless  we  have  paid  special  attention  to 
history,  have  any  idea  of.i  The  volume  does  not 
constitute,  then,  a  contribution  to  that  theme  that 
has  interested  the  last  few  generations  so  much, — 
the  supposed  continuous  progress  of  the  race  and 
its  marvellous  advance, — but  rather  emphasizes  that 
puzzling  question,  how  is  it  that  men  make  im- 
portant discoveries  and  inventions,  and  then,  after 
a  time,  forget  about  them  so  that  they  have  to  be 
made  over  again!  \  This  is  as  true  in  medical  science 
and  in  medical  practice  as  in  every  other  depart- 
ment of  human  effort.  It  does  not  seem  possible 
that  mankind  should  ever  lose  sight  of  the  progress 
in  medicine  and  surgery  that  has  been  made  in  re- 
cent years,  yet  the  history  of  the  past  would  seem  to 
indicate  that,  in  spite  of  its  unlikelihood,  it  might 
well  come  about.  Whether  this  is  the  lesson  of  the 
book  or  not,  I  shall  leave  readers  to  judge,  for  it  was 
not  intentionally  put  into  it. 

OUR  lady's  day  in  harvest,  1911. 


CONTENTS 

CHAPTER  PAGE 

I.     Introduction 1 

II.  Great  Physicians  in  Early  Christian  Times       23 

III.  Great  Jewish  Physicians       .         .         .         .61 

IV.  Maimonides 90 

V.  Great  Arabian  Physicians     .        .        .        .109 

VI.  The  Medical  School  at  Salerno  .                  ,141 
VII.  Const antine  Africanus           .         .         .         .163 
VIII.  Medieval  Women  Physicians         .         .         .177 
IX.  Mondino  and  the  Medical  School  of  Bologna     202 
X.  Great  Surgeons  of  the  Medieval  Univer- 
sities        234 

XL  Guy  de  Chauliac 282 

XII.  Medieval  Dentistry — Giovanni  of  Arcoli      313 

XIII.  CUSANUS    AND    THE    FlRST   SUGGESTION  OF  LAB- 

ORATORY Methods  in  Medicine  .         .     336 

XIV.  Basil   Valentine,  Last  of  the  Alchemists, 

First  of  the  Chemists        .        .        .        .349 

APPENDICES 

I.     St.  Luke  the  Physician  .        .        .        .381 

II.     Science  at  the  Medieval  Universities        .     400 

III.    Medieval  Popularization  of  Science  .        .427 


"  Of  making  many  books  there  is  no  end." — 
Eccles.  xii,  12  (circa  1000  B.C.). 

"  The  little  by-play  between  Socrates  and  Euthy- 
demus  suggests  an  advanced  condition  of  medical 
literature :  '  Of  course,  you  who  have  so  many  books 
are  going  in  for  being  a  doctor/  says  Socrates,  and 
then  he  adds,  '  there  are  so  many  books  on  medi- 
cine, you  know.'  As  Dyer  remarks,  whatever  the 
quality  of  these  books  may  have  been,  their  number 
must  have  been  great  to  give  point  to  this  chaff. ' ' — 
Aequanimitas,  William  Osler,  M.D.,  F.E.S.,  Blakis- 
tons,  Philadelphia,  1906. 

"  Augescunt  aliae  gentes,  aliae  minuuntur; 
Inque  brevi  spatio  mutantur  saecla  animantum, 
Et,  quasi  cursores  vitai  lampada  tradunt." 

— OVID. 

One  nation  rises  to  supreme  power  in  the  world, 
while  another  declines,  and,  in  a  brief  space  of  time, 
the  sovereign  people  change,  transmitting,  like 
racers,  the  lamp  of  life  to  some  other  that  is  to  suc- 
ceed them. 

"  There  is  one  Science  of  Medicine  which  is  con- 
cerned with  the  inspection  of  health  equally  in  all 
times,  present,  past  and  future." 

— PLATO. 


I 

INTRODUCTION 

Under  the  term  Old-Time  Medicine  most  people 
probably  think  at  once  of  Greek  medicine,  since  that 
developed  in  what  we  have  called  ancient  history, 
and  is  farthest  away  from  us  in  date.  As  a  matter 
of  fact,  however,  mnch  more  is  known  abont  Greek 
medical  writers  than  those  of  any  other  period  ex- 
cept the  last  century  or  two.  Our  histories  of  medi- 
cine discuss  Greek  medicine  at  considerable  length 
and  practically  all  of  the  great  makers  of  medicine 
in  subsequent  generations  have  been  influenced  by 
the  Greeks.  Greek  physicians  whose  works  have 
come  down  to  us  seem  nearer  to  us  than  the  medical 
writers  of  any  but  the  last  few  centuries.  As  a  con- 
sequence we  know  and  appreciate  very  well  as  a  rule 
how  much  Greek  medicine  accomplished,  but  in  our 
admiration  for  the  diligent  observation  and  breadth 
of  view  of  the  Greeks,  we  are  sometimes  prone  to 
think  that  most  of  the  intervening  generations  down 
to  comparatively  recent  times  made  very  little 
progress  and,  indeed,  scarcely  retained  what  the 
Greeks  had  done.  The  Eomans  certainly  justify 
this  assumption  of  non-accomplishment  in  medicine, 
but  then  in  everything  intellectual  Rome  was  never 
much  better  than  a  weak  copy  of  Greek  thought.  In 
science  the  Romans  did  nothing  at  all  worth  while 
talking  about.    All  their  medicine  they  borrowed 


2  OLD-TIME  MAKERS  OF  MEDICINE 

from  the  Greeks,  adding  nothing  of  their  own.  What 
food  for  thought  there  is  in  the  fact,  that  in  spite 
of  all  Rome's  material  greatness  and  wide  empire, 
her  world  dominance  and  vaunted  prosperity,  we 
have  not  a  single  great  original  scientific  thought 
from  a  Roman. 

Though  so  much  nearer  in  time  medieval  medicine 
seems  much  farther  away  from  us  than  is  Greek 
medicine.  Most  of  us  are  quite  sure  that  the  im- 
pression of  distance  is  due  to  its  almost  total  lack 
of  significance.  It  is  with  the  idea  of  showing  that 
the  medieval  generations,  as  far  as  was  possible  in 
their  conditions,  not  only  preserved  the  old  Greek 
medicine  for  us  in  spite  of  the  most  untoward  cir- 
cumstances, but  also  tried  to  do  whatever  they  could 
for  its  development,  and  actually  did  much  more 
than  is  usually  thought,  that  this  story  of  "  Old- 
Time  Makers  of  Medicine  "  is  written.  It  repre- 
sents a  period — that  of  the  Middle  Ages — that  is,  or 
was  until  recently,  probably  more  misunderstood 
than  any  other  in  human  history.  The  purpose  of 
the  book  is  to  show  at  least  the  important  head- 
lands that  lie  along  the  stream  of  medical  thought 
during  the  somewhat  more  than  a  thousand  years 
from  the  fall  of  the  Roman  Empire  under  Augus- 
tulus  (476)  until  the  discovery  of  America.  After 
that  comes  modern  medicine,  for  with  the  sixteenth 
century  the  names  and  achievements  of  the  workers 
in  medicine  are  familiar — Paracelsus,  Vesalius,  Co- 
lumbus, Servetus,  Csesalpinus,  Eustachius,  Varolius, 
Sylvius  are  men  whose  names  are  attached  to  great 
discoveries  with  which  even  those  who  are  without 
any  pretence  to  knowledge  of  medical  history  are 


INTRODUCTION  3 

not  unacquainted.  In  spite  of  nearly  four  centuries 
of  distance  in  time  these  men  seem  very  close  to  us. 
Their  lives  will  be  reserved  for  a  subsequent  volume, 
"  Our  Forefathers  in  Medicine.' ' 

It  is  usually  the  custom  to  contemn  the  Middle 
Ages  for  their  lack  of  interest  in  culture,  in  educa- 
tion, in  literature,  in  a  word,  in  intellectual  accom- 
plishment of  any  and  every  kind,  but  especially  in 
science.  There  is  no  doubt  about  the  occurrence  of 
marked  decadence  in  the  intellectual  life  of  the  first 
half  of  this  period.  This  has  sometimes  been  at- 
tributed to  what  has  been  called  the  inhibitory  effect 
of  Christianity  on  worldly  interests.  Eeligion  is 
said  to  have  occupied  people  so  much  with  thoughts 
of  the  other  world  that  the  beauties  and  wonders,  as 
well  as  much  of  the  significance,  of  the  world  around 
them  were  missed.  Those  who  talk  thus,  however, 
forget  entirely  the  circumstances  which  brought 
about  the  serious  decadence  of  interest  in  culture 
and  science  at  this  time.  The  Eoman  Empire  had 
been  the  guardian  of  letters  and  education  and 
science.  While  the  Eomans  were  not  original  in 
themselves,  at  least  they  had  shown  intense  interest 
in  what  was  accomplished  by  the  Greeks  and  their 
imitation  had  often  risen  to  heights  that  made  them 
worthy  of  consideration  for  themselves.  They  were 
liberal  patrons  of  Greek  art  and  of  Greek  literature, 
and  did  not  neglect  Greek  science  and  Greek  medi- 
cine. Galen's  influence  was  due  much  more  to  the 
prominence  secured  by  him  as  the  result  of  his  stay 
in  Eome  than  would  have  been  possible  had  he 
stayed  in  Asia.  There  are  many  other  examples  of 
Eoman  patronage  of  literature  and  science  that 


4  OLD-TIME  MAKERS  OF  MEDICINE 

might  be  mentioned.  As  we  shall  see,  Eome  drained 
Greece  and  Asia  Minor  of  their  best,  and  appropri- 
ated to  herself  the  genius  products  of  the  Spanish 
Peninsula.  Eome  had  a  way  of  absorbing  what  was 
best  in  the  provinces  for  herself. 

Just  as  soon  as  Rome  was  cut  off  from  intimate 
relations  with  the  provinces  by  the  inwandering  of 
barbarians,  intellectual  decadence  began.  The  im- 
perial city  itself  had  never  been  the  source  of  great 
intellectual  achievement,  and  the  men  whom  we  think 
of  as  important  contributors  to  Rome's  literature 
and  philosophy  were  usually  not  born  within  the 
confines  of  the  city.  It  is  surprising  to  take  a  list 
of  the  names  of  the  Latin  writers  whom  we  are  ac- 
customed to  set  down  simply  as  Romans  and  note 
their  birthplaces.  Rome  herself  gave  birth  to  but 
a  very  small  percentage  of  them.  Virgil  was  born 
at  Mantua,  Cicero  at  Arpinum,  Horace  out  on  the 
Sabine  farm,  the  Plinys  out  of  the  city,  Terence  in 
Africa,  Persius  up  in  Central  Italy  somewhere,  Livy 
at  Padua,  Martial,  Quintilian,  the  Senecas,  and 
Lucan  in  Spain.  When  the  government  of  the  city 
ceased  to  be  such  as  assured  opportunity  for  those 
from  outside  who  wanted  to  make  their  way,  deca- 
dence came  to  Roman  literature.  Large  cities  have 
never  in  history  been  the  fruitful  mothers  of  men 
who  did  great  things.  Genius,  and  even  talent,  has 
always  been  born  out  of  the  cities  in  which  it  did 
its  work.  It  is  easy  to  understand,  then,  the  deca- 
dence of  the  intellectual  life  that  took  place  as  the 
Empire  degenerated. 

For  the  sake  of  all  that  it  meant  in  the  Roman 
Empire  to  look  towards  Rome  at  this  time,  however. 


INTRODUCTION  5 

it  seemed  better  to  the  early  Christians  to  establish 
the  centre  of  their  jurisdiction  there.  Necessarily, 
then,  in  all  that  related  to  the  purely  intellectual  life, 
they  came  under  the  influences  that  were  at  work  at 
Eome  at  this  time.  During  the  first  centuries  they 
suffered  besides  from  the  persecutions  directed 
against  them  by  the  Emperors  at  various  times,  and 
these  effectually  prevented  any  external  manifesta- 
tions of  the  intellectual  life  on  the  part  of  Christians. 
It  took  much  to  overcome  this  serious  handicap,  but 
noteworthy  progress  was  made  in  spite  of  obstacles, 
and  by  the  time  of  Constantine  many  important  of- 
ficials of  the  Empire,  the  educated  thinking  classes 
of  Eome,  had  become  Christians.  After  the  conver- 
sion of  the  Emperor  opportunities  began  to  be  af- 
forded, but  political  disturbances  consequent  upon 
barbarian  influences  still  further  weakened  the  old 
civilization  until  much  of  the  intellectual  life  of  it 
almost  disappeared. 

Gradually  the  barbarians,  finding  the  Roman  Em- 
pire decadent,  crept  in  on  it,  and  though  much  more 
of  the  invasion  was  peaceful  than  we  have  been  ac- 
customed to  think,  the  Romans  simply  disappearing 
because  family  life  had  been  destroyed,  children  had 
become  infrequent,  and  divorce  had  become  ex- 
tremely common,  it  was  not  long  before  they  re- 
placed the  Romans  almost  entirely.  These  new  peo- 
ples had  no  heritage  of  culture,  no  interest  in  the 
intellectual  life,  no  traditions  of  literature  or 
science,  and  they  had  to  be  gradually  lifted  up  out 
of  their  barbarism.  This  was  the  task  that  Chris- 
tianity had  to  perform.  That  it  succeeded  in  ac- 
complishing it  is  one  of  the  marvels  of  history. 


6  OLD-TIME  MAKERS  OF  MEDICINE 

The  Church's  first  grave  duty  was  the  preserva- 
tion of  the  old  records  of  literature  and  of  science. 
Fortunately  the  monasteries  accomplished  this  task, 
which  would  have  been  extremely  perilous  for  the 
precious  treasures  involved  but  for  the  favorable 
conditions  thus  afforded.  Libraries  up  to  this  time 
were  situated  mainly  in  cities,  and  were  subject  to 
all  the  vicissitudes  of  fire  and  war  and  other  modes 
of  destruction  that  came  to  cities  in  this  disturbed 
period.  Monasteries,  however,  were  usually  situ- 
ated in  the  country,  were  built  very  substantially 
and  very  simply,  and  the  life  in  them  formed  the 
best  possible  safeguard  against  fire,  which  worked 
so  much  havoc  in  cities.  As  we  shall  see,  however, 
not  only  were  the  old  records  preserved,  but  ex- 
cerpts from  them  were  collated  and  discussed  and 
applied  by  means  of  direct  observation.  This  led 
the  generations  to  realize  more  and  more  the  value 
of  the  old  Greek  medicine  and  made  them  take 
further  precautions  for  its  preservation. 

The  decadence  of  the  early  Middle  Ages  was  due 
to  the  natural  shifting  of  masses  of  population  of 
this  time,  while  the  salvation  of  scientific  and  liter- 
ary traditions  was  due  to  the  one  stable  element  in 
all  these  centuries — the  Church.  Far  from  Chris- 
tianity inhibiting  culture,  it  was  the  most  important 
factor  for  its  preservation,  and  it  provided  the  best 
stimulus  and  incentive  for  its  renewed  development 
just  as  soon  as  the  barbarous  peoples  were  brought 
to  a  state  of  mind  to  appreciate  it. 

Bearing  this  in  mind,  it  is  easier  to  understand 
the  course  of  medical  traditions  through  the  Middle 
Ages,  and  especially  in  the  earlier  period,  with  re- 


INTRODUCTION  7 

gard  to  which  our  documents  are  comparatively 
scanty,  and  during  which  the  disturbed  conditions 
made  medical  developments  impossible,  and  any- 
thing more  than  the  preservation  of  the  old  authors 
out  of  the  question.  The  torch  of  medical  illumina- 
tion lighted  at  the  great  Greek  fires  passes  from 
people  to  people,  never  quenched,  though  often  burn- 
ing low  because  of  unfavorable  conditions,  but  some- 
times with  new  fuel  added  to  its  flame  by  the  con- 
tributions of  genius.  The  early  Christians  took  it 
up  and  kept  it  lighted,  and,  with  the  Jewish  physi- 
cians, carried  it  through  the  troublous  times  of  the 
end  of  the  old  order,  and  then  passed  it  on  for  a 
while  to  the  Arabs.  Then,  when  favorable  condi- 
tions had  developed  again,  Christian  schools  and 
scholars  gave  it  the  opportunity  to  burn  brightly 
for  several  centuries  at  the  end  of  the  Middle  Ages. 
This  medieval  age  is  probably  the  most  difficult 
period  of  medical  history  to  understand  properly, 
but  it  is  worth  while  taking  the  trouble  to  follow 
out  the  thread  of  medical  tradition  from  the  Greeks 
to  the  Renaissance  medical  writers,  who  practically 
begin  modern  medicine  for  us. 

It  is  easy  to  understand  that  Christianity's  in- 
fluence on  medicine,  instead  of  hampering,  was  most 
favorable.  The  Founder  of  Christianity  Himself 
had  gone  about  healing  the  sick,  and  care  for  the 
ailing  became  a  prominent  feature  of  Christian 
work.  One  of  the  Evangelists,  St.  Luke,  was  a 
physician.  It  was  the  custom  a  generation  ago,  and 
even  later,  when  the  Higher  Criticism  became  pop- 
ular, to  impugn  the  tradition  as  to  St.  Luke  having 
been  a  physician,  but  this  has  all  been  undone,  and 


8  OLD-TIME  MAKERS  OF  MEDICINE 

Harnack's  recent  book,  "  Luke  the  Physician, ' ' 
makes  it  very  clear  that  not  only  the  Third  Gospel, 
but  also  the  Acts,  could  only  have  been  written  by  a 
man  thoroughly  familiar  with  the  Greek  medical 
terms  of  his  time,  and  who  had  surely  had  the  ad- 
vantage of  a  training  in  the  medical  sciences  at 
Alexandria.  This  makes  such  an  important  link 
in  medical  traditions  that  a  special  chapter  has  been 
devoted  to  it  in  the  Appendix. 

Very  early  in  Christianity  care  for  the  ailing  poor 
was  taken  up,  and  hospitals  in  our  modern  sense 
of  the  term  became  common  in  Christian  com- 
munities. There  had  been  military  hospitals  before 
this,  and  places  where  those  who  could  afford  to 
pay  for  service  were  kept  during  illness.  Our  mod- 
ern city  hospital,  however,  is  a  Christian  institution. 
Besides,  deformed  and  ailing  children  were  cared 
for  and  homes  for  foundlings  were  established.  Be- 
fore Christianity  the  power  even  of  life  and  death  of 
the  parents  over  their  children  was  recognized, 
and  deformed  or  ailing  children,  or  those  that  for 
some  reason  were  not  wanted,  were  exposed  until 
they  died.  Christianity  put  an  end  to  this,  and  in 
two  classes  of  institutions,  the  hospitals  and  the 
asylums,  abundant  opportunity  for  observation  of 
illness  was  afforded.  Just  as  soon  as  Christianity 
came  to  be  free  to  establish  its  institutions  publicly, 
hospitals  became  very  common.  The  Emperor 
Julian,  usually  known  as  the  Apostate,  who  hoped 
to  re-establish  the  old  Eoman  Olympian  religion, 
wrote  to  Oribasius,  one  of  the  great  physicians  of 
this  time,  who  was  also  an  important  official  of  his 
household,   that  these   Christians   had   established 


INTRODUCTION  9 

everywhere  hospitals  in  which  not  only  their  own 
people,  but  also  those  who  were  not  Christians,  were 
received  and  cared  for,  and  that  it  would  be  idle  to 
hope  to  counteract  the  influence  of  Christianity  until 
corresponding  institutions  could  be  erected  by  the 
government. 

From  the  very  beginning,  or,  at  least,  just  as  soon 
as  reasonable  freedom  from  persecution  gave  op- 
portunity for  study,  Christian  interest  in  the  med- 
ical sciences  began  to  manifest  itself.  Nemesius, 
for  instance,  a  Bishop  of  Edessa  in  Syria,  wrote 
toward  the  end  of  the  fourth  century  a  little  work 
in  Greek  on  the  nature  of  man,  which  is  a  striking 
illustration  of  this.  Nemesius  was  what  in  modern 
times  would  be  called  a  philosopher,  that  is,  a  spec- 
ulative thinker  and  writer,  with  regard  to  man's 
nature,  rather  than  a  physical  scientist.  He  was 
convinced,  however,  that  true  philosophy  ought  to 
be  based  on  a  complete  knowledge  of  man,  body  and 
soul,  and  that  the  anatomy  of  his  body  ought  to  be  a 
fundamental  principle.  It  is  in  this  little  volume 
that  some  enthusiastic  students  have  found  a  de- 
scription that  is  to  them  at  least  much  more  than  a 
hint  of  knowledge  of  the  circulation  of  the  blood. 
Hyrtl  doubts  that  the  passage  in  question  should 
be  made  to  signify  as  much  as  has  been  suggested, 
but  the  occurrence  of  any  even  distant  reference  to 
such  a  subject  at  this  time  shows  that,  far  from  there 
being  neglect  of  physical  scientific  questions,  men 
were  thinking  seriously  about  them. 

Just  as  soon  as  Christianity  brought  in  a  more 
peaceful  state  of  affairs  and  had  so  influenced  the 
mass  of  the  people  that  its  place  in  the  intellectual 


10  OLD-TIME  MAKERS  OF  MEDICINE 

life  could  be  felt,  there  comes  a  period  of  cultural 
development  represented  in  philosophy  by  the 
Fathers  of  the  Church,  and  during  which  we  have  a 
series  of  important  contributors  to  medical  litera- 
ture. The  first  of  these  was  Aetius,  whose  career 
and  works  are  treated  more  fully  in  the  chapter  on 
"  Great  Physicians  in  Early  Christian  Times.' '  He 
was  followed  by  Alexander  of  Tralles,  probably  a 
Christian,  for  his  brother  was  the  architect  of  Santa 
Sophia,  and  by  Paul  of  iEgina,  with  regard  to  whom 
we  know  only  what  is  contained  in  his  medical 
writings,  but  whose  contemporaries  were  nearly  all 
Christians.  Their  books  are  valuable  to  us,  partly 
because  they  contain  quotations  from  great  Greek 
writers  on  medicine,  not  always  otherwise  available, 
but  also  because  they  were  men  who  evidently  knew 
the  subject  of  medicine  broadly  and  thoroughly, 
made  observations  for  themselves,  and  controlled 
what  they  learned  from  the  Greek  forefathers  in 
medicine  by  their  own  experience.  Just  at  the  be- 
ginning of  the  Middle  Ages,  then,  under  the  foster- 
ing care  of  Christianity  there  is  a  period  of  consid- 
erable importance  in  the  history  of  medical  litera- 
ture. It  is  one  of  the  best  proofs  that  we  have  not 
only  that  Christianity  did  not  hamper  medical  de- 
velopment, but  that,  directly  and  indirectly,  by  the 
place  that  it  gave  to  the  care  of  the  ailing  in  life  as 
well  as  the  encouragement  afforded  to  the  intel- 
lectual life,  it  favored  medical  study  and  writing. 

A  very  interesting  chapter  in  the  story  of  the 
early  Christian  physician  is  to  be  found  in  what  we 
know  of  the  existence  of  women  physicians  in  the 
fourth  and  fifth  centuries.    Theodosia,  the  mother 


INTRODUCTION  11 

of  St.  Procopius  the  martyr,  was,  according  to 
Carptzovius,  looked  upon  as  an  excellent  physician 
in  Eome  in  the  early  part  of  the  fourth  century.  She 
suffered  martyrdom  under  Diocletian.  There  was 
also  a  Nicerata  who  practised  at  Constantinople  un- 
der the  Emperor  Arcadius.  It  is  said  that  to  her 
St.  John  Chrysostom  owed  the  cure  of  a  serious  ill- 
ness. From  the  very  beginning  Christian  women 
acted  as  nurses,  and  deaconesses  were  put  in  charge 
of  hospitals.  Fabiola,  at  Eome,  is  the  foundress  of 
the  first  important  hospital  in  that  city.  The  story 
of  these  early  Christian  women  physicians  has  been 
touched  upon  in  the  chapter  on  "  Medieval  Women 
Physicians, ' '  as  an  introduction  to  this  interesting 
feature  of  Salernitan  medical  education. 

During  the  early  Christian  centuries  much  was 
owed  to  the  genius  and  the  devotion  to  medicine  of 
distinguished  Jewish  physicians.  Their  sacred  and 
rabbinical  writers  always  concerned  themselves 
closely  with  medicine,  and  both  the  Old  Testament 
and  the  Talmud  must  be  considered  as  containing 
chapters  important  for  the  medical  history  of  the 
periods  in  which  they  were  written.  At  all  times 
the  Jews  have  been  distinguished  for  their  knowl- 
edge of  medicine,  and  all  during  the  Middle  Ages 
they  are  to  be  found  prominent  as  physicians.  They 
were  among  the  teachers  of  the  Arabs  in  the  East 
and  of  the  Moors  in  Spain.  They  were  probably 
among  the  first  professors  at  Salerno  as  well  as  at 
Montpellier.  Many  prominent  rulers  and  ecclesi- 
astics selected  Jewish  physicians.  Some  of  these 
made  distinct  contributions  to  medicine,  and  a  num- 
ber of  them  deserve  a  place  in  any  account  of  medi- 


12  OLD-TIME  MAKERS  OF  MEDICINE 

cine  in  the  making  during  the  Middle  Ages.    One  of 
them,  Maimonides,  to  whom  a  special  chapter  is  de- 
voted, deserves  a  place  among  the  great  makers  of 
medicine  of  all  time,  because  of  the  influence  that 
he  exerted  on  his  own  and  succeeding  generations. 
Any  story  of  the  preservation  and  development  of 
medical  teaching  and  medical  practice  during  the 
Middle  Ages  would  be  decidedly  incomplete  without 
due  consideration  of  the  work  of  Jewish  physicians. 
Western  medical  literature  followed  Eoman  lit- 
erature in  other  departments,   and  had  only  the 
Greek  traditions  at  second  hand.    During  the  dis- 
turbance occasioned  by  the  invasion  of  the  barbari- 
ans there  was  little  opportunity  for  such  leisure  as 
would  enable  men  to  devote  themselves  with  tran- 
quillity to  medical  study  and  writing.  Medical  tradi- 
tions were  mainly  preserved  in  the  monasteries. 
Cassiodorus,  who,  after  having  been  Imperial  Prime 
Minister,  became  a  monk,  recommended  particularly 
the  study  of  medicine  to   the  monastic  brethren. 
With  the  foundation  of  the  Benedictines,  medicine 
became  one  of  the  favorite  studies  of  the  monks, 
partly  for  the  sake  of  the  health  of  the  brethren 
themselves,  and  partly  in  order  that  they  might  be 
helpful  to  the  villages  that  so  often  gathered  round 
their  monasteries.     There  is  a  well-grounded  tradi- 
tion that  at  Monte  Cassino  medical  teaching  was  one 
of  the  features  of  the  education  provided  there  by 
the  monks.    It  is  generally  conceded  that  the  Bene- 
dictines had  much  to  do  with  the  foundation  of 
Salerno.    In  the  convents  for  women  as  well  as  the 
monasteries  for  men  serious  attention  was  given  to 
medicine.    Women  studied  medicine  and  were  pro- 


INTRODUCTION  13 

fessors  in  the  medical  department  of  Salerno.  Other 
Italian  universities  followed  the  example  thus  set, 
and  so  there  is  abundant  material  for  the  chapter  on 
"  Medieval  Women  Physicians. ' ' 

The  next  phase  of  medical  history  in  the  medieval 
period  brings  us  to  the  Arabs.  Utterly  uninterested 
in  culture,  education,  or  science  before  the  time  of 
Mohammed,  with  the  growth  of  their  political  power 
and  the  foundation  of  their  capitals,  the  Arab 
Caliphs  took  up  the  patronage  of  education.  They 
were  the  rulers  of  the  cities  of  Asia  Minor  in  which 
Greek  culture  had  taken  so  firm  a  hold,  and  captive 
Greece  has  always  led  its  captors  captive.  With 
the  leisure  that  came  for  study,  Arabians  took  up 
the  cultivation  of  the  Greek  philosophers,  especially 
Aristotle,  and  soon  turned  their  attention  also  to  the 
Greek  physicians  Hippocrates  and  Galen.  For  some 
four  hundred  years  then  they  were  in  the  best  posi- 
tion to  carry  on  medical  traditions.  Their  teachers 
were  the  Christian  and  Jewish  physicians  of  the 
cities  of  Asia  Minor,  but  soon  they  themselves  be- 
came distinguished  for  their  attainments,  and  for 
their  medical  writings.  Interestingly  enough,  more 
of  their  distinguished  men  flourished  in  Spain  than 
in  Asia  Minor.  We  have  suggested  an  explanation 
for  this  in  the  fact  that  Spain  had  been  one  of  the 
most  cultured  provinces  of  the  Eoman  Empire,  pro- 
viding practically  all  the  writers  of  the  Silver  Age 
of  Latin  literature,  and  evidently  possessing  a 
widely  cultured  people.  It  was  into  this  province, 
not  yet  utterly  decadent  from  the  presence  of  the 
northern  Goths,  that  the  Moors  came  and  readily 
built  up  a  magnificent  structure  of  culture  and  edu- 


14  OLD-TIME  MAKERS  OF  MEDICINE 

cation  on  what  had  been  the  highest  development  of 
Roman  civilization. 

The  influence  of  the  Arabs  on  Western  civiliza- 
tion, and  especially  on  the  development  of  science 
in  Europe,  has  been  much  exaggerated  by  certain 
writers.  Closely  in  touch  with  Greek  thought  and 
Greek  literature  during  the  eighth,  ninth,  and  tenth 
centuries,  it  is  easy  to  understand  that  the  Arabian 
writers  were  far  ahead  of  the  Christian  scholars  of 
Europe  of  the  same  period,  who  were  struggling  up 
out  of  the  practical  chaos  that  had  been  created  by 
the  coming  of  the  barbarians,  and  who,  besides,  had 
the  chance  for  whatever  Greek  learning  came  to 
them  only  through  the  secondary  channels  of  the 
Latin  writers.  Rome  had  been  too  occupied  with 
politics  and  aggrandizement  ever  to  become  cul- 
tured. In  spite  of  this  heritage  from  the  Greeks, 
decadence  took  place  among  the  Arabs,  and,  as  the 
centuries  go  on,  what  they  do  becomes  more  and 
more  trivial,  and  their  writing  has  less  significance. 
Just  the  opposite  happened  in  Europe.  There,  there 
was  noteworthy  progressive  development  until  the 
magnificent  climax  of  thirteenth  century  accomplish- 
ment was  reached.  It  is  often  said  that  Europe 
owed  much  to  the  Arabs  for  this,  but  careful  analysis 
of  the  factors  in  that  progress  shows  that  very  lit- 
tle came  from  the  Arabs  that  was  good,  while  not 
a  little  that  was  unfortunate  in  its  influence  was  bor- 
rowed from  them  with  the  translations  of  the  Greek 
authors  from  that  language,  which  constituted  the 
main,  indeed  often  the  only,  reason  why  Arabian 
writers  were  consulted. 

With  the  foundation  of  the  medical  school  of 


INTRODUCTION  15 

Salerno  in  the  tenth  century,  the  modern  history  of 
medical  education  may  be  said  to  begin,  for  it  had 
many  of  the  features  that  distinguish  our  modern 
university  medical  schools.  Its  professors  often 
came  from  a  distance  and  had  travelled  extensively 
for  purposes  of  study;  they  attracted  patients  of 
high  rank  from  nearly  every  part  of  Europe,  and 
these  were  generous  in  their  patronage  of  the  school. 
Students  came  from  all  over,  from  Africa  and  Asia, 
as  well  as  Europe,  and  when  abuses  of  medical  prac- 
tice began  to  creep  in,  a  series  of  laws  were  made 
creating  a  standard  of  medical  education  and  reg- 
ulating the  practice  of  medicine,  that  are  interesting 
anticipations  of  modern  movements  of  the  same 
kind.  Finally  a  law  was  passed  requiring  three  years 
of  preliminary  work  in  logic  and  philosophy  before 
medicine  might  be  taken  up,  and  then  four  years  at 
medicine,  with  a  subsequent  year  of  practice  with  a 
physician  before  a  license  to  practise  for  one's  self 
was  issued.  In  addition  to  this  there  was  a  still 
more  surprising  feature  in  the  handing  over  of  the 
department  of  women's  diseases  to  women  pro- 
fessors, and  the  consequent  opening  up  of  licensure 
to  practise  medicine  to  a  great  many  women  in  the 
southern  part  of  Italy.  The  surprise  that  all  this 
should  have  taken  place  in  the  south  of  Italy  is 
lessened  by  recalling  the  fact  that  the  lower  end 
of  the  Italian  peninsula  had  been  early  colonized  by 
Greeks,  that  its  name  in  later  times  was  Magna 
Grsecia,  and  that  the  stimulus  of  Greek  tradition 
has  always  been  especially  favorable  to  the  develop- 
ment of  scientific  medicine. 

Salerno's  influence  on  Bologna  is  not  difficult  to 


16  OLD-TIME  MAKEES  OF  MEDICINE 

trace,  and  the  precious  tradition  of  surgery  par- 
ticularly, which  was  carried  to  the  northern  uni- 
versity, served  to  initiate  a  period  of  surgery  last- 
ing nearly  two  centuries,  during  which  we  have  some 
of  the  greatest  contributions  to  this  branch  of  med- 
ical science  that  were  ever  made.  The  development 
of  the  medical  school  at  Bologna  anticipated  by  but 
a  short  time  that  of  a  series  of  schools  in  the  north 
Italian  universities.  Padua,  Piacenza,  Pisa,  and 
Vicenza  had  medical  schools  in  the  later  Middle 
Ages,  the  works  of  some  of  whose  professors  have 
attracted  attention.  It  was  from  these  north 
Italian  medical  schools  that  the  tradition  of  close 
observation  in  medicine  and  of  thoroughly  scientific 
surgery  found  its  way  to  Paris.  Lanfranc  was  the 
carrier  of  surgery,  and  many  French  students  who 
went  to  Italy  came  back  with  Italian  methods.  In 
the  fourteenth  century  Guy  de  Chauliac  made  the 
grand  tour  in  Italy,  and  then  came  back  to  write  a 
text-book  of  surgery  that  is  one  of  the  monuments 
in  this  department  of  medical  science.  Before  his 
time,  Montpellier  had  attracted  attention,  but  now  it 
came  to  be  looked  upon  as  a  recognized  centre  of 
great  medical  teaching.  The  absence  of  the  Popes 
from  Italy  and  the  influence  of  their  presence  at 
Avignon  made  itself  felt.  While  culture  and  edu- 
cation declined  in  Italy  in  the  midst  of  political  dis- 
turbances, they  advanced  materially  at  the  south  of 
France. 

For  our  generation  undoubtedly  the  most  interest- 
ing chapter  in  the  history  of  medieval  medicine  is 
that  which  tells  of  the  marvellous  development  of 
surgery  that  took  place  in  the  thirteenth  and  four- 


INTRODUCTION  17 

teenth  centuries.  Considerable  space  has  been  de- 
voted to  this,  because  it  represents  not  only 
an  important  phase  of  the  history  of  medicine, 
and  recalls  the  names  and  careers  of  great 
makers  of  medicine,  but  also  because  it  il- 
lustrates exquisitely  the  possibility  of  important 
discoveries  in  medicine  being  made,  applied  success- 
fully for  years,  and  then  being  lost  or  completely 
forgotten,  though  contained  in  important  medical 
books  that  were  always  available  for  study.  The 
more  we  know  of  this  great  period  in  the  history  of 
surgery,  the  more  is  the  surprise  at  how  much  was 
accomplished,  and  how  many  details  of  our  modern 
surgery  were  anticipated.  Most  of  us  have  had 
some  inkling  of  the  fact  that  anaesthesia  is  not  new, 
and  that  at  various  times  in  the  world's  history  men 
have  invented  methods  of  producing  states  of  sensi- 
bility in  which  more  or  less  painless  operations  were 
possible.  Very  few  of  us  have  realized,  however, 
the  perfection  to  which  anaesthesia  was  developed, 
and  the  possibility  this  provided  for  the  great 
surgeons  of  the  later  medieval  centuries  to  do  opera- 
tions in  all  the  great  cavities  of  the  body,  the  skull, 
the  thorax,  and  the  abdomen,  quite  as  they  are  done 
in  our  own  time  and  apparently  with  no  little  degree 
of  success. 

Of  course,  any  such  extensive  surgical  interven- 
tion even  for  serious  affections  would  have  been 
worse  than  useless  under  the  septic  conditions  that 
would  surely  have  prevailed  if  certain  principles  of 
antisepsis  were  not  applied.  Until  comparatively 
recent  years  we  have  been  quite  confident  in  our  as- 
surance that  antisepsis  and  asepsis  were  entirely 


18  OLD-TIME  MAKERS  OF  MEDICINE 

modern  developments  of  surgery.  More  knowledge, 
however,  of  the  history  of  surgery  has  given  a  seri- 
ous set-back  to  this  self-complacency,  and  now  we 
know  that  the  later  medieval  surgeons  understood 
practical  antisepsis  very  well,  and  applied  it  success- 
fully. They  used  strong  wine  as  a  dressing  for 
their  wounds,  insisted  on  keeping  them  clean,  and 
not  allowing  any  extraneous  material  of  any  kind, 
ointments  or  the  like,  to  be  used  on  them.  As  a  con- 
sequence they  were  able  to  secure  excellent  results 
in  the  healing  of  wounds,  and  they  were  inclined  to 
boast  of  the  fact  that  their  incisions  healed  by  first 
intention  and  that,  indeed,  the  scar  left  after  them 
was  scarcely  noticeable.  We  know  that  wine  would 
make  a  good  antiseptic  dressing,  but  until  we  actu- 
ally read  the  reports  of  the  results  obtained  by  these 
old  surgeons,  we  had  no  idea  that  it  could  be  used  to 
such  excellent  purpose.  Antisepsis,  like  anaesthesia, 
was  marvellously  anticipated  by  the  surgical  fore- 
fathers of  the  medieval  period. 

It  has  always  seemed  to  me  that  the  story  of 
Medieval  Dentistry  presented  an  even  better  il- 
lustration of  a  great  anticipatory  development  of 
surgery.  This  department  represents  only  a  small 
surgical  specialty,  but  one  which  even  at  that  period 
was  given  over  to  specialists,  who  were  called  denta- 
tores.  Guy  de  Chauliac's  review  of  the  dentistry  of 
his  time  and  the  state  of  the  specialty,  as  pictured 
by  John  of  Arcoli,  is  likely  to  be  particularly  inter- 
esting, because  if  there  is  any  department  of  med- 
ical practice  that  we  are  sure  is  comparatively  re- 
cent in  origin,  it  is  dentistry.  Here,  however,  we 
find  that  practically  all  our  dental  manipulations, 


INTRODUCTION  19 

the  filling  of  teeth,  artificial  dentures,  even  ortho- 
dontia, were  anticipated  by  the  dentists  of  the  Mid- 
dle Ages.  "We  have  only  the  compressed  account  of 
it  which  is  to  be  found  in  text-books  of  general 
surgery,  and  while  in  this  they  give  mainly  a  her- 
itage from  the  past,  yet  even  this  suffices  to 
give  us  a  picture  very  surprising  in  its  detailed 
anticipation  of  much  that  we  have  been  inclined 
to  think  of  as  quite  modern  in  invention  and  dis- 
covery. 

Medicine  developed  much  more  slowly  than 
surgery,  or,  rather,  lagged  behind  it,  as  it  seems 
nearly  always  prone  to  do.  Surgical  problems  are 
simple,  and  their  solution  belongs  to  a  great  extent 
to  a  handicraft.  That  is,  after  all,  what  chirurgy, 
the  old  form  of  our  word  surgery,  means.  Medical 
problems  are  more  complex  and  involve  both  art 
and  science,  so  that  solutions  of  them  are  often 
merely  temporary  and  lack  finality.  During  the 
Middle  Ages,  however,  and  especially  towards  the 
end  of  them,  the  most  important  branches  of  medi- 
cine, diagnosis  and  therapeutics,  took  definite  shape 
on  the  foundations  that  lie  at  the  basis  of  our  mod- 
ern medical  science.  We  hear  of  percussion  for  ab- 
dominal conditions,  and  of  the  most  careful  study 
of  the  pulse  and  the  respiration.  There  are  charts 
for  the  varying  color  of  the  urine,  and  of  the  tints 
of  the  skin.  With  Nicholas  of  Cusa  there  came  the 
definite  suggestion  of  the  need  of  exact  methods  of 
diagnosis.  A  mathematician  himself,  he  wished  to 
introduce  mathematical  methods  into  medical 
diagnosis,  and  suggested  that  the  pulse  should  be 
counted  in  connection  with  the  water  clock,  the 


20  OLD-TIME  MAKERS  OF  MEDICINE 

water  that  passed  being  weighed,  in  order  to  get 
very  definite  comparative  values  for  the  pulse  rate 
under  varying  conditions,  and  also  that  the  specific 
gravity  of  fluids  from  the  body  should  be  ascer- 
tained in  order  to  get  another  definite  datum  in  the 
knowledge  of  disease.  It  was  long  before  these  sug- 
gestions were  to  bear  much  fruit,  but  it  is  interest- 
ing to  find  them  so  clearly  expressed. 

At  the  very  end  of  the  Middle  Ages  came  the 
father  of  modern  pharmaceutical  chemistry,  Basil 
Valentine.  Already  the  spirit  that  was  to  mean  so 
much  for  scientific  investigation  in  the  Eenaissance 
period  was  abroad.  Valentine,  however,  owes  little 
to  anything  except  his  own  investigations,  and  they 
were  surprisingly  successful,  considering  the  cir- 
cumstances of  time  and  place.  His  practical  sug- 
gestions so  far  as  drugs  were  concerned  did  not 
prove  to  have  enduring  value,  but  then  this  has  been 
a  fate  shared  by  many  of  the  masters  of  medicine. 
There  were  many  phases  of  medical  practice,  how- 
ever, that  he  insisted  on  in  his  works.  He  believed 
that  the  best  agent  for  the  cure  of  the  disease  was 
nature,  and  that  the  physician's  main  business  must 
be  to  find  out  how  nature  worked,  and  then  foster 
her  efforts  or  endeavor  to  imitate  them.  He  in- 
sisted, also  that  personal  observation,  both  of  pa- 
tients and  drugs,  was  more  important  than  book 
knowledge.  Indeed,  he  has  some  rather  strong  ex- 
pressions with  regard  to  the  utter  valuelessness  of 
book  information  in  subjects  where  actual  experi- 
ence and  observation  are  necessary.  It  gives  a  con- 
ceit of  knowledge  quite  unjustified  by  what  is  really 
known. 


INTRODUCTION  21 

What  is  interesting  about  all  these  men  is  that 
they  faced  the  same  problems  in  medicine  that  we 
have  to,  in  much  the  same  temper  of  mind  that  we 
do  ourselves,  and  that,  indeed,  they  succeeded  in 
solving  them  almost  as  well  as  we  have  done,  in  spite 
of  all  that  might  be  looked  for  from  the  accumula- 
tion of  knowledge  ever  since. 

It  was  very  fortunate  for  the  after  time  that  in 
the  period  now  known  as  the  Eenaissance,  after  the 
invention  of  printing,  there  were  a  number  of  seri- 
ous, unselfish  scholars  who  devoted  themselves  to 
the  publication  in  fine  printed  editions  of  the  works 
of  these  old-time  makers  of  medicine.  If  the  neglect 
of  them  that  characterized  the  eighteenth  and  early 
nineteenth  centuries  had  been  the  rule  at  the  end 
of  the  fifteenth  and  during  the  sixteenth  century,  we 
would  almost  surely  have  been  without  the  possibil- 
ity of  ever  knowing  that  so  many  serious  physicians 
lived  and  studied  and  wrote  large  important  tomes 
during  the  Middle  Ages.  For  our  forefathers  of  a 
few  generations  ago  had  very  little  knowledge,  and 
almost  less  interest,  as  to  the  Middle  Ages,  which 
they  dismissed  simply  as  the  Dark  Ages,  quite  sure 
that  nothing  worth  while  could  possibly  have  come 
out  of  the  Nazareth  of  that  time.  What  they  knew 
about  the  people  who  had  lived  during  the  thousand 
years  before  1500  only  seemed  to  them  to  prove  the 
ignorance  and  the  depths  of  superstition  in  which 
they  were  sunk.  That  medieval  scholars  should 
have  written  books  not  only  well  worth  preservation, 
but  containing  anticipations  of  modern  knowledge, 
and,  though  of  course  they  could  not  have  known 
that,  even  significant  advances  over  their  own  sci- 


22  OLD-TIME  MAKERS  OF  MEDICINE 

entific  conditions,  would  have  seemed  to  them  quite 
absurd. 

Fortunately  for  us,  then,  the  editions  of  the  early 
printed  books,  so  many  of  them  monuments  of  learn- 
ing and  masterpieces  of  editorial  work  with  regard 
to  medieval  masters  of  medicine,  were  lying  in 
libraries  waiting  to  be  unearthed  and  restudied  dur- 
ing the  nineteenth  century.  German  and  French 
scholars,  especially  during  the  last  generation,  have 
recovered  the  knowledge  of  this  thousand  years  of 
human  activity,  and  we  know  now  and  can  sym- 
pathetically study  how  the  men  of  these  times  faced 
their  problems,  which  were  very  much  those  of  our 
own  time,  in  almost  precisely  the  same  spirit  as  we 
do  ours  at  the  present  time,  and  that  their  solutions 
of  them  are  always  interesting,  often  thorough  and 
practical,  and  more  frequently  than  we  would  like  to 
think  possible,  resemble  our  own  in  many  ways. 
For  the  possibility  of  this  we  are  largely  indebted 
originally  to  the  scholars  of  the  Eenaissance.  With- 
out their  work  that  of  our  investigators  would  have 
been  quite  unavailing.  It  is  to  be  hoped,  however, 
that  our  recovery  of  this  period  will  not  be  followed 
by  any  further  eclipse,  though  that  seems  to  be 
almost  the  rule  of  human  history,  but  that  we  shall 
continue  to  broaden  our  sympathetic  knowledge  of 
this  wonderful  medieval  period,  the  study  of  which 
has  had  so  many  surprises  in  store  for  us. 


II 


GREAT  PHYSICIANS  IN  EAELY  CHRISTIAN 

TIMES 

What  we  know  of  the  life  of  the  Founder  of 
Christianity  and  how  much  He  did  for  the  ailing 
poor  would  make  us  expect  that  the  religion  that  He 
established  would  foster  the  care  and  the  cure  of 
suffering  humanity.  As  we  have  outlined  in  the  In- 
troduction, the  first  of  the  works  of  Christian  service 
that  was  organized  was  the  care  of  the  sick.  At  first 
a  portion  of  the  bishop's  house  was  given  over  to 
the  shelter  of  the  ailing,  and  a  special  order  of  as- 
sistants to  the  clergy,  the  deaconesses,  took  care  of 
them.  As  Christians  became  more  numerous,  spe- 
cial hospitals  were  founded,  and  these  became  pub- 
lic institutions  just  as  soon  as  freedom  from  perse- 
cution allowed  the  Christians  the  liberty  to  give 
overt  expression  to  their  feelings  for  the  poor. 
While  hospitals  of  limited  capacity  for  such  special 
purposes  as  the  sheltering  of  slaves  or  of  soldiers 
and  health  establishments  of  various  kinds  for  the 
wealthy  had  been  erected  before  Christianity,  this 
was  the  first  time  that  anyone  who  was  ill,  no  mat- 
ter what  the  state  of  his  pecuniary  resources,  could 
be  sure  to  find  shelter  and  care.  The  expression  of 
the  Emperor  Julian  the  Apostate,  that  admission  to 
these  hospitals  was  not  limited  to  Christians,  is  the 

23 


24  OLD-TIME  MAKERS  OF  MEDICINE 

best  possible  evidence  of  the  liberal  charity  that  in- 
spired them. 

The  ordinary  passing  student  of  the  history  of 
medicine  or  of  hospital  foundation  and  organization, 
can  have  no  idea  of  the  magnitude  of  some  of  these 
institutions,  and  their  importance  in  the  life  of  the 
time,  unless  it  is  especially  pointed  out.  St.  Basil, 
about  the  middle  of  the  fourth  century,  erected  what 
was  spoken  of  as  "  a  city  for  the  sick,"  before  the 
gates  of  Csesarea.  Gregory  of  Nazianzen,  his 
friend,  says  "  that  well  built  and  furnished  houses 
stood  on  both  sides  of  streets  symmetrically  laid  out 
about  the  church,  and  contained  rooms  for  the  sick, 
and  the  infirm  of  every  variety  were  intrusted  to 
the  care  of  doctors  and  nurses.' '  There  were  sep- 
arate buildings  for  strangers,  for  the  poor,  and  for 
the  ailing,  and  comfortable  dwellings  for  the  physi- 
cians and  nurses.  An  important  portion  of  the  in- 
stitution was  set  apart  for  the  care  of  lepers,  which 
constituted  a  prominent  feature  in  Basil's  work  in 
which  he  himself  took  a  special  interest.  Earlier  in 
the  same  century  Helena,  the  mother  of  the  Em- 
peror Constantine,  had  built  similar  institutions 
around  Jerusalem,  and  during  this  same  century 
nearly  everywhere  we  have  evidence  of  organi- 
zation of  hospitals  and  of  care  for  the  ailing 
poor. 

Not  only  were  hospitals  erected,  but  arrangements 
were  made  for  the  care  of  the  ailing  poor  in  their 
own  homes  and  for  the  visitation  of  them,  and  for 
the  bringing  to  places  adapted  for  their  care  and 
treatment  of  such  as  were  found  on  the  street,  or 
neglected  in  their  homes.    The  Church  evidently 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   25 

considered  itself  bound  to  care  for  men's  bodies  as 
well  as  their  souls,  and  many  of  the  expressions  in 
common  use  among  Christians  referred  to  this  fact. 
Eeligion  itself  was  spoken  of  as  a  medicine  of  the 
soul  and  the  body.  Christianity  was  denned  as  the 
religion  of  healing.  The  word  salvation  had  a  refer- 
ence to  both  body  and  soul.  Baptism  was  spoken 
of  as  the  bath  of  the  soul,  the  holy  Eucharist  as 
the  elixir  of  immortal  life,  and  penance  as  the  medi- 
cine of  the  soul.  It  is  not  surprising  to  find,  then, 
that  Harnack  has  found  among  the  texts  that  il- 
lustrate the  history  of  early  Christian  literature  this 
one :  "  In  every  community  there  shall  be  at  least 
one  widow  appointed  to  assist  women  who  are 
stricken  with  illness,  and  this  widow  shall  be 
trained  in  her  duties,  neat  and  careful  in  her  ways, 
shall  not  be  self-seeking,  must  not  indulge  too  freely 
in  wine  in  order  that  she  may  be  able  to  take  up 
her  duties  at  night  as  well  as  by  day,  and  shall  con- 
sider it  her  duty  to  keep  the  Church  officials  in- 
formed of  all  that  seems  necessary." 

The  saving  of  deformed  and  ailing  infants  or 
children  whose  parents  did  not  care  to  have  the 
trouble  of  rearing  them,  required  the  establishment 
by  the  Christians  of  another  set  of  institutions, 
Foundling  Asylums  and  Hospitals  for  Children. 
Until  the  coming  of  Christianity  parents  were  sup- 
posed to  have  the  right  of  life  and  death  over  their 
children,  and  no  one  questioned  it.  In  every  coun- 
try in  the  world  until  the  coming  of  Christianity  this 
had  always  been  the  case.  Besides,  there  were  in- 
stitutions for  the  care  of  the  old.  These  are  the 
classes  of  mankind  who  are  especially  liable  to  suf- 


26  OLD-TIME  MAKERS  OF  MEDICINE 

fer  from  disease,  and  the  opportunity  to  study 
human  ailments  in  such  institutions  could  scarcely 
help  but  provide  facilities  for  clinical  observa- 
tion such  as  had  not  existed  before.  Unfor- 
tunately the  work  of  Christianity  was  hampered, 
first  by  the  Eoman  persecutions,  and  then  later  by 
the  invasion  of  the  barbarians,  who  had  to  be  edu- 
cated and  lifted  up  to  a  higher  plane  of  civilization 
before  they  could  be  brought  to  appreciate  the  value 
of  medical  science,  much  less  contribute  to  its  de- 
velopment. 

Harnack,  whose  writings  in  the  higher  criticism 
of  Scripture  have  attracted  so  much  attention  in  re- 
cent years,  began  his  career  in  the  study  of  Christian 
antiquities  with  a  monograph  on  Medical  Features 
of  Early  Christianity.1  He  mentions  altogether 
some  sixteen  physicians  who  reached  distinc- 
tion in  the  earliest  days  of  Christianity.  Some 
of  these  were  priests,  some  of  them  bishops, 
as  Theodotos  of  Laodicea;  Eusebius,  Bishop  of 
Eome;  Basilios,  Bishop  of  Ancyra,  and  at  least 
one,  Hierakas,  was  the  founder  of  a  religious  order. 
The  first  Christian  physicians  came  mainly  from 
Syria,  as  might  be  expected,  for  here  the  old  Greek 
medical  traditions  were  active.  Among  them  must 
be  enumerated  Cosmas  and  Damian,  physicians  who 
were  martyred  in  the  persecution  of  Diocletian,  and 
who  have  been  chosen  as  the  patrons  of  the  medical 
profession.  Justinian  erected  a  famous  church  to 
them.  It  became  the  scene  of  pilgrimages.  Organi- 
zations of  various  kinds  since,  as  the  College  of  St. 

1 "  Medicinisches  aus  der  Aeltesten  Kirchen  Geschichte,"  Leipzig, 
1892. 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   27 

Come,  and  medical  societies,  have  been  named  after 
them. 

Some  idea  of  the  interest  of  ecclesiastics  in  med- 
ical affairs  may  be  gathered  from  a  letter  of  Bishop 
Theodoret  of  Cyrus,  directed  to  the  prefect  of  the 
city,  when  he  was  about  to  leave  the  place.  He  wrote 
(see  Puschmann,  Vol.  I.,  p.  494) :  "  When  I  took 
up  the  Bishopric  of  Cyrus  I  made  every  effort  to 
bring  in  from  all  sides  the  arts  that  would  be  useful 
to  the  people.  I  succeeded  in  persuading  skilled 
physicians  to  take  up  their  residence  here.  Among 
these  is  a  very  pious  priest,  Peter,  who  practises 
medicine  with  great  skill,  and  is  well  known  for  his 
care  for  the  people.  Now  that  I  am  about  to  leave 
the  city,  some  of  those  who  came  at  my  invitation 
are  preparing  also  to  go.  Peter  seems  resolved  to 
do  this.  I  appeal  to  your  highness,  therefore,  in 
order  to  commend  him  to  your  special  care.  He 
handles  patients  with  great  skill  and  brings  about 
many  cures." 

Distinguished  Christian  writers  and  scholars,  and 
the  Fathers  of  the  Church  in  the  early  centuries,  evi- 
dently paid  much  attention  to  medicine.  Tertullian 
speaks  of  medical  science  as  the  sister  of  philosophy, 
and  has  many  references  to  the  medical  doctrines 
discussed  in  his  time.  Lactantius,  in  his  work,  "  De 
Opificio  Dei,"  has  much  to  say  with  regard  to  the 
human  body  as  representing  the  necessity  for  design 
in  creation.  His  teleological  arguments  have  much 
more  force  now  than  they  would  have  had  for  peo- 
ple generally  twenty  years  ago.  We  have  come  back 
to  recognize  the  place  of  teleology.  Clement  of 
Alexandria  was  an  early  Christian  temperance  ad- 


28  OLD-TIME  MAKERS  OF  MEDICINE 

vocate,  who  argued  that  the  use  of  wine  was  only 
justified  when  it  did  good  as  a  medicine.  The  prob- 
lems of  embryology  and  of  diseases  of  childhood 
interested  him  as  they  did  many  other  of  the  early 
Christian  writers. 

AETIUS 

The  first  great  Christian  physician  whose  works 
meant  much  for  his  own  time,  and  whose  writings 
have  become  a  classic  in  medicine,  was  Aetius  Ami- 
denus,  that  is,  Aetius  of  Amida,  who  was  born  in  the 
town  of  that  name  in  Mesopotamia,  on  the  upper 
Tigris  (now  Diarbekir),  and  who  flourished  about 
the  middle  of  the  sixth  century.  His  medical  studies, 
as  he  has  told  us  himself,  were  made  at  Alexandria. 
After  having  attracted  attention  by  his  medical 
learning  and  skill,  he  became  physician  to  one  of 
the  emperors  at  Byzantium,  very  probably  Justinian, 
(527-565).  He  seems  to  have  been  succeeded  in  the 
special  post  that  was  created  for  him  at  court  by 
Alexander  of  Tralles,  the  second  of  the  great  Chris- 
tian physicians.  There  is  no  doubt  that  Aetius  was 
a  Christian,  for  he  mentions  Christian  mysteries, 
and  appeals  to  the  name  of  the  Saviour  and  the 
martyrs.  He  was  evidently  a  man  of  wide  reading, 
for  he  quotes  from  practically  every  important  med- 
ical writer  before  his  time.  Indeed,  he  is  most 
valuable  for  the  history  of  medicine,  because  he  gives 
us  some  idea  of  the  mode  of  treatment  of  various 
subjects  by  predecessors  whose  fame  we  know,  but 
none  of  whose  works  have  come  to  us.  His  official 
career    and   the   patronage   of   the    Emperor,    the 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES  29 

breadth  of  his  scholarship,  and  the  thoroughly  prac- 
tical character  of  his  teaching,  show  how  medical 
science  and  medical  art  were  being  developed  and 
encouraged  at  this  time. 

Aetius'  work  that  is  preserved  for  us  is  known  in 
medical  literature  as  his  sixteen  books  on  medical 
practice.  In  most  of  the  manuscript  it  is  divided 
into  four  Tetrabibloi,  or  four  book  parts,  each  of 
which  consists  of  four  sections  called  Logoi  in 
Greek,  Sermones  in  Latin.  This  work  embraces  all 
the  departments  of  medicine,  and  has  a  considerable 
portion  devoted  to  surgery,  but  most  of  the  im- 
portant operations  and  the  chapters  on  fractures 
and  dislocations  are  lacking.  Aetius  himself  an- 
nounces that  he  had  prepared  a  special  work  on 
surgery,  but  this  is  lost.  Doubtless  the  important 
chapters  that  we  have  noted  as  lacking  in  his  work 
would  be  found  in  this.  He  is  much  richer  in 
pathology  than  most  of  the  older  writers,  at  least 
of  the  Christian  era ;  for  instance,  Gurlt  says  that  he 
treats  this  feature  of  the  subject  much  more  ex- 
tensively even  than  Paulus  ^Eginetus,  but  most  of 
his  work  is  devoted  to  therapeutics. 

At  times  those  who  read  these  old  books  from  cer- 
tain modern  standpoints  are  surprised  to  find  such 
noteworthy  differences  between  writers  on  medicine, 
who  are  separated  sometimes  only  by  a  generation, 
and  sometimes  by  not  more  than  a  century,  in  what 
regards  the  comparative  amount  of  space  given  to 
pathology,  etiology,  and  therapeutics.  Just  exactly 
the  same  differences  exist  in  our  own  day,  however. 
We  all  know  that  for  those  who  want  pathology  and 
etiology  the  work  of  one  of  our  great  teachers  is  to 


30  OLD-TIME  MAKERS  OF  MEDICINE 

be  consulted,  while  for  therapeutics  it  is  better  to 
go  to  someone  else.  When  we  find  such  differences 
among  the  men  of  the  olden  time  we  are  not  so 
apt  to  look  at  them  with  sympathetic  discrimina- 
tion, as  we  do  with  regard  to  our  contemporaries. 
We  may  even  set  them  down  to  ignorance  rather 
than  specialization  of  interest.  These  differences 
depend  on  the  attitude  of  mind  of  the  physician,  and 
are  largely  the  result  of  his  own  personal  equation. 
They  do  not  reflect  in  any  way  either  on  his  judg- 
ment or  on  the  special  knowledge  of  his  time,  but 
are  the  index  of  his  special  receptivity  and  teaching 
habit. 

Aetius'  first  and  second  books  are  taken  up  en- 
tirely with  drugs.  The  first  book  contains  a  list  of 
drugs  arranged  according  to  the  Greek  alphabet.  In 
the  third  book  other  remedial  measures,  dietetic, 
manipulative,  and  even  operative,  are  suggested. 
In  these  are  included  venesection,  the  opening  of  an 
artery,  cupping,  leeches,  and  the  like.  The  fourth 
and  fifth  books  take  up  hygiene,  special  dietetics,  and 
general  pathology.  In  the  sixth  book  what  the 
Germans  call  special  pathology  and  therapy  begins 
with  the  diseases  of  the  head.  The  first  chapter 
treats  of  hydrocephalus.  In  this  same  book  rabies 
is  treated.  What  Aetius  has  consists  mainly  of 
quotations  from  previous  authors,  many  of  whom  he 
had  evidently  read  with  great  care. 

Concerning  those  "  bitten  by  a  rabid  dog  or  those 
who  fear  water, ' '  Gurlt  has  quoted  the  following  ex- 
pression, with  regard  to  which  most  people  will  be 
quite  ready  to  agree  with  him  when  he  says  that  it 
contains  a  great  deal  of  truth,  usually  thought  to  be 


GEE  AT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   31 

of  much  later  origin :  ' '  When,  therefore,  any  one 
has  been  bitten  by  a  rabid  dog  the  treatment  of  the 
wound  must  be  undertaken  just  as  soon  as  possible, 
even  though  the  bite  should  be  small  and  only  super- 
ficial. One  thing  is  certain,  that  none  of  those  who 
are  not  rightly  treated  escape  the  fatal  effect.  The 
first  thing  to  do  is  to  make  the  wound  larger,  the 
mouth  of  it  being  divided  and  dilated  by  the  scalpel. 
Then  every  portion  of  it  and  the  surrounding  tissues 
must  be  firmly  pressed  upon  with  the  definite  pur- 
pose of  causing  a  large  efflux  of  blood  from  the  part. 
Then  the  wound  should  be  deeply  cauterized,  etc.,, 

There  are  special  chapters  devoted  to  eye  and  ear 
diseases,  and  to  various  affections  of  the  face.  Un- 
der this  the  question  of  tattooing  and  its  removal 
comes  in.  It  is  surprising  how  much  Aetius  has 
with  regard  to  such  nasal  affections  as  polyps  and 
ulcers  and  bleedings  from  the  nose.  In  this  book, 
however,  he  treats  only  of  their  medicinal  treatment. 
What  he  has  to  say  about  affections  of  the  teeth  is 
so  interesting  that  it  deserves  a  paragraph  or  two 
by  itself. 

He  had  much  to  say  with  regard  to  the  nervous 
supply  of  the  mucous  membranes  of  the  gums, 
tongue,  and  mouth,  and  taught  that  the  teeth  re- 
ceived nerves  through  the  small  hole  existing  at  the 
end  of  every  root.  For  children  cutting  teeth  he 
advised  the  chewing  of  hard  objects,  and  thought 
that  the  chewing  of  rather  hard  materials  was  good 
also  for  the  teeth  of  adults.  For  fistulas  leading 
to  the  roots  of  teeth  he  suggests  various  irritant 
treatments,  and,  if  they  do  not  succeed,  recommends 
the  removal  of  the  teeth.    He  seems  to  have  known 


32  OLD-TIME  MAKERS  OF  MEDICINE 

much  about  affections  of  the  gums  and  recognizes  a 
benignant  and  malignant  epulis.  He  thought  that 
one  form  of  epulis  was  due  to  inflammation  of  a 
chronic  character,  and  suggests  that  if  remedies  do 
not  succeed  it  should  be  removed.  His  work  is  of 
interest  mainly  as  showing  that  even  at  this  time, 
when  the  desire  for  information  of  this  kind  is  usu- 
ally supposed  to  have  been  in  abeyance,  physicians 
were  gathering  information  about  all  sorts  even  of 
the  minor  ailments  of  mankind,  gathering  what  had 
been  written  about  them,  commenting  on  it,  adding 
their  own  observations,  and  in  general  trying  to 
solve  the  problems  as  well  as  they  could. 

Aetius  seems  to  have  had  a  pretty  good  idea  of 
diphtheria.  He  speaks  of  it  in  connection  with 
other  throat  manifestations  under  the  heading  of 
"  crusty  and  pestilent  ulcers  of  the  tonsils."  He 
divides  the  anginas  generally  into  four  kinds.  The 
first  consists  of  inflammation  of  the  fauces  with  the 
classic  symptoms,  the  second  presents  no  inflamma- 
tion of  the  mouth  nor  of  the  fauces,  but  is  compli- 
cated by  a  sense  of  suffocation — apparently  our 
croup.  The  third  consists  of  external  and  internal 
inflammation  of  the  mouth  and  throat,  extending 
towards  the  chin.  The  fourth  is  an  affection  rather 
of  the  neck,  due  to  an  inflammation  of  the  vertebrae 
—retropharyngeal  abscess — that  may  be  followed 
by  luxation  and  is  complicated  by  great  difficulty  of 
respiration.  All  of  these  have  as  a  common  symp- 
tom difficulty  of  swallowing.  This  is  greater  in  one 
variety  than  in  another  at  different  times.  In  cer- 
tain affections  even  "  drinks  when  taken  are  re- 
turned through  the  nose." 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   33 

Hypertrophy  of  the  tonsils — Aetius  speaks  of 
them  as  glands — is  to  be  treated  by  various 
astringent  remedies,  bnt  if  these  fail  the  structures 
should  be  excised.  His  description  of  the  excision 
is  rather  clear  and  detailed.  The  patient  should  be 
put  in  a  good  full  light,  and  the  mouth  should  be 
held  open  and  each  gland  pulled  forward  by  a  hook 
and  excised.  The  operator  should  be  careful,  how- 
ever, only  to  excise  those  portions  that  are  beyond 
the  natural  size,  for  if  any  of  the  natural  substance 
of  the  gland  is  cut  into,  or  if  the  incision  is  made 
beyond  the  projecting  portion  of  the  tonsil,  there  is 
grave  danger  of  serious  hemorrhage.  After  ex- 
cision a  mixture  of  water  and  vinegar  should  be  kept 
in  the  mouth  for  some  time.  This  should  be  admin- 
istered cold  in  order  to  prevent  the  flow  of  blood. 
After  this  very  cold  water  should  be  taken. 

In  this  same  book,  Chapter  L,  he  treats  of  for- 
eign bodies  in  the  respiratory  and  upper  digestive 
tracts.  If  there  is  anything  in  the  larynx  or  the 
bronchial  tubes  the  attempt  must  be  made  to  secure 
its  ejection  by  the  production  of  coughing  or  sneez- 
ing. If  the  foreign  body  can  be  seen  it  should  be 
grasped  with  a  pincers  and  removed.  If  it  is  in 
the  esophagus,  Aetius  suggests  that  the  patient 
should  be  made  to  swallow  a  sponge  dipped  in 
grease,  or  a  piece  of  fat  meat,  to  either  of  which  a 
string  has  been  attached,  in  order  that  the  foreign 
body  may  be  caught  and  drawn  out.  If  it  seems 
preferable  to  carry  the  body  on  into  the  stomach, 
the  swallowing  of  large  mouthfuls  of  fresh  bread 
or  other  such  material  is  recommended. 

With  regard  to  goitre,  Aetius  has  some  interest- 


34  OLD-TIME  MAKERS  OF  MEDICINE 

ing  details.  He  says  that  "  all  tumors  occurring 
in  the  throat  region  are  called  bronchoceles,  for 
every  tumor  among  the  ancients  was  called  a  cele, 
and,  though  the  name  is  common  to  them,  they  differ 
very  much  from  one  another."  Some  of  them  are 
fatty,  some  of  them  are  pultaceous,  some  of  them 
are  cancerous,  and  some  of  them  he  calls  honey 
tumors,  because  of  a  honey-like  humor  they  contain. 
"  Sometimes  they  are  due  to  a  local  dilatation  of  the 
blood  vessels,  and  this  is  most  frequently  connected 
with  parturition,  apparently  being  due  to  the  draw- 
ing of  the  breath  being  prevented  or  repressed  dur- 
ing the  most  violent  pains  of  the  patient.  Such 
local  dilatation  at  this  point  of  the  veins  is  incurable, 
but  there  are  also  hard  tumors  like  scirrhus  and 
malignant  tumors,  and  those  of  great  size.  With 
the  exception  of  these  last,  all  the  tumors  of  this 
region  are  easily  cured,  yielding  either  to  surgery 
or  to  remedies.  Surgery  must  be  adapted  to  the 
special  tumor,  whether  it  be  honey-like  or  fatty,  or 
pultaceous."  The  prognosis  of  goitrous  tumors  is 
much  better  than  might  be  expected,  but  evidently 
Aetius  saw  a  number  of  the  functional  disturbances 
and  enlargements  of  the  thyroid  gland,  which  are 
so  variable  in  character  as  apparently  to  be  quite 
amenable  to  treatment. 

Aetius '  treatment  of  the  subject  of  varicosities 
is  quite  complete  in  its  suggestions.  "  The  term 
varices,"  he  says,  "  is  applied  to  dilated  veins, 
which  occur  sometimes  in  connection  with  the  testes 
and  sometimes  in  the  limbs.  Operations  on 
testicular  varices  patients  do  not  readily  consent  to ; 
those  on  the  limbs  may  be  cured  in  several  ways. 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES  35 

First,  simple  section  of  the  skin  lying  above  the 
dilated  vessel  is  made,  and  with  the  hook  it  is  sep- 
arated from  the  neighboring  tissues  and  tied.  After 
this  the  dilated  portion  is  removed  and  pressure 
applied  by  means  of  a  bandage.  The  patient  is 
ordered  to  remain  quiet,  but  with  the  legs  higher 
than  the  head.  Some  people  prefer  treatment  by 
means  of  the  cautery.' '  Gurlt,  in  his  "  History  of 
Surgery,"  calls  attention  to  the  fact  that  two  of  our 
modern  methods  of  treating  varicose  veins  are  thus 
discussed  in  Aetius,  that  by  ligation  and  that  by 
the  cautery.  The  cautery  was  applied  over  a  space 
the  breadth  of  a  finger  at  several  points  along  the 
dilated  veins. 

Aetius'  chapters  on  obstetrics  and  gynaecology 
are  of  special  interest,  because,  while  we  are  prone 
to  think  that  gynaecology  particularly  is  a  compara- 
tively modern  development  of  surgery,  this  surgical 
authority  of  the  early  Middle  Ages  treats  it  rather 
exhaustively.  His  sixteenth  book  is  for  the  most 
part  (one  hundred  and  eleven  chapters  of  it)  de- 
voted to  these  two  subjects.  He  has  a  number  of 
interesting  details  in  the  first  thirty-six  chapters 
with  regard  to  conception,  pregnancy,  labor,  and 
lactation,  which  show  how  practical  were  the  views 
of  the  physicians  of  the  time.  Gurlt  has  given  us 
some  details  of  his  chapters  on  diseases  of  the 
breast.  Aetius  differentiates  phagedenic  and  rodent 
ulcers  and  cancer.  All  the  ordinary  forms  of 
phagedenic  ulcer  yield  to  treatment,  while  malignant 
growths  are  rendered  worse  by  them.  Where  ulcers 
are  old,  he  suggests  the  removal  of  their  thickened 
edges  by  the  cautery,  for  this  hastens  cure  and 


36  OLD-TIME  MAKERS  OF  MEDICINE 

preventsN  hemorrhage.  With  regard  to  cancer,  he 
quotes  from  Archigenes  and  Leonides.  He  says 
that  these  tumors  are  very  frequent  in  women,  and 
quite  rare  in  men.  Even  at  this  time  cancer  had 
been  observed  and  recognized  in  the  male  breast. 
He  emphasizes  the  fact  that  cancerous  nodules  be- 
come prominent  and  become  attached  to  surround- 
ing tissues.  There  are  two  forms,  those  with  ulcer, 
and  those  without.  He  describes  the  enlargement 
of  the  veins  that  follows,  the  actual  varicosities,  and 
the  dusky  or  livid  redness  of  the  parts  which  seem 
to  be  soft,  but  are  really  very  hard.  He  says 
that  they  are  often  complicated  by  very  painful  con- 
ditions, and  that  they  cause  enlargement  of  the 
glands  and  of  the  arms.  The  pain  may  spread  to 
the  clavicle  and  the  scapula,  and  he  seems  to  think 
that  it  is  the  pain  that  causes  the  enlargement  of 
the  glands  at  a  distance. 

His  description  of  ulcerative  cancer  of  the  breast 
is  very  striking.  He  says  that  it  erodes  without 
cause,  penetrating  ever  deeper  and  deeper,  and  can- 
not be  stopped  until  it  emits  a  secretion  worse  than 
the  poison  of  wild  beasts,  copious  and  abominable 
to  the  smell.  With  these  other  symptoms  pains  are 
present.  This  form  of  cancer  is  especially  made 
worse  by  drugs  and  by  all  manner  of  manipulation. 
The  paragraph  from  Leonides  quoted  by  Aetius 
gives  a  description  of  operation  for  cancer  of  the 
breast,  in  which  he  insists  particularly  on  the  ex- 
tensive removal  of  tissue  and  the  free  use  of  the 
cautery.  "  The  cautery  is  used  at  first  in  order  to 
prevent  bleeding,  but  also  because  it  helps  to  destroy 
the  remains  of  diseased  tissues.     When  the  burning 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES    37 

is  deep,  prognosis  is  much  better.  Even  in  cases 
where  indurated  tumors  of  the  breast  occur  that 
might  be  removed  without  danger  of  bleeding,  it  is 
better  to  use  the  cautery  freely,  though  the  amputa- 
tion of  such  a  portion  down  to  the  healthy  parts  may 
suffice."    Aetius  quotes  this  with  approval. 

Others  before  Aetius  had  suggested  the  connec- 
tion between  hypertrophy  of  the  clitoris  and  cer- 
tain exaggerated  manifestations  of  the  sexual  in- 
stinct, and  the  development  of  vicious  sexual  habits. 
As  might  be  expected  from  this  first  great  Christian 
physician  and  surgeon,  he  emphasizes  this  etiology 
for  certain  cases,  and  outlines  an  operation  for  it. 
This  operation  had  been  suggested  before,  but  Aetius 
goes  into  it  in  detail  and  describes  just  how  the 
operation  should  be  done,  so  as  to  secure  complete 
amputation  of  the  enlarged  organ,  yet  without  in- 
jury. He  warns  of  the  danger  of  removing  more 
than  just  the  structure  itself,  because  this  may  give 
rise  to  ugly  and  bothersome  scars.  After  the  opera- 
tion a  sponge  wet  with  astringent  wine  should  be  ap- 
plied, or  cold  water,  especially  if  there  is  much 
tendency  to  bleeding,  and  afterwards  a  sponge  with 
manna  or  frankincense  scattered  over  it  should  be 
bound  on.  He  treats  of  other  pathological  condi- 
tions of  the  female  genitalia,  varicose  veins,  growths 
of  various  kinds,  hypertrophy  of  the  portio  vaginalis 
uteri,  an  operation  for  which  is  described,  and  of 
various  tumors.  He  describes  epithelioma  very 
clearly,  enumerates  its  most  frequent  locations  in 
their  order,  lays  down  its  bad  prognosis,  and  hence 
the  necessity  for  early  operation  with  entire  re- 
moval of  the  new  growth  whenever  possible.    He 


38  OLD-TIME  MAKERS  OF  MEDICINE 

feared  hemorrhage  very  much,  however,  and  warns 
with  regard  to  it,  and  evidently  had  had  some  very 
unfortunate  experiences  in  the  treatment  of  these 
conditions. 

Aetius  seems  to  have  had  as  thoroughly  scientific 
an  interest  in  certain  phases  of  chemistry  apart 
from  medicine  as  any  educated  physician  of  the 
modern  time  might  have.  Mr.  A.  P.  Laurie,  in  his 
"  Materials  of  the  Printer's  Craft/ ' *  calls  attention 
to  the  fact  that  the  earliest  reference  to  the  use  of 
drying  oil  for  varnish  is  made  by  the  physician 
Aetius. 

Aetius,  or  Aetios,  to  use  for  the  nonce  the  Greek 
spelling  of  his  name,  which  sometimes  occurs  in 
medical  literature,  and  should  be  known,  has  been 
the  subject  of  very  varied  estimation  at  different 
times.  About  the  time  of  the  Eenaissance  he  was 
one  of  the  first  of  the  early  writers  on  medicine  ac- 
corded the  honor  of  printing,  and  then  was  reprinted 
many  times,  so  that  his  estimation  was  very  high. 
"With  the  reawakening  of  clinical  medicine  in  the 
seventeenth  century  his  reputation  waxed  again,  and 
Boerhaave  declared  that  the  works  of  Aetius  had 
as  much  importance  for  physicians  as  had  the  Pan- 
dects of  Justinian  for  lawyers.  This  high  estima- 
tion had  survived  almost  from  the  time  of  the 
Eenaissance,  when  Cornelius  went  so  far  as  to  say: 
"  Believe  me,  that  whoever  is  deeply  desirous  of 
studying  things  medical,  if  he  would  have  the  whole 
of  Galen  abbreviated  and  the  whole  of  Oribasius  ex- 
tended, and  the  whole  of  Paulus  (of  ^Egina)  ampli- 
fied, if  he  would  have  all  the  special  remedies  of  the 

xFoulis,  London  and  Edinburgh,  1910. 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   39 

old  physicians  as  well  in  pharmacy  as  in  surgery 
boiled  down  to  a  summa  for  all  affections,  he  will 
find  it  in  Aetius."  Naturally  enough,  this  exag- 
gerated estimation  was  followed  by  a  reaction,  in 
which  Aetius  came  to  be  valued  at  much  less  than  he 
deserved.  After  all  is  taken  into  account  in  the 
vicissitudes  of  his  fame,  it  is  clear,  however,  that  he 
is  one  of  the  most  important  links  in  the  chain  of 
medical  tradition,  and  himself  worthy  to  be  classed 
among  makers  of  medicine  for  his  personal  observa- 
tions and  efforts  to  pass  on  the  teachings  of  the  old 
to  succeeding  generations. 

ALEXANDER  OF  TRALLES 

An  even  more  striking  example  than  the  life  and 
work  of  Aetius  as  evidence  for  the  encouragement 
and  patronage  of  medicine  in  early  Christian  times, 
is  to  be  found  in  the  career  of  Alexander  of  Tralles, 
whose  writings  have  been  the  subject  of  most  care- 
ful attention  in  the  Eenaissance  period  and  in  our 
own,  and  who  must  be  considered  one  of  the  great 
independent  thinkers  in  medicine.  While  it  is  usu- 
ally assumed  that  whatever  there  was  of  medical 
writing  during  the  Middle  Ages  was  mere  copying 
and  compilation,  here  at  least  is  a  man  who  could 
not  only  judiciously  select,  but  who  could  critically 
estimate  the  value  of  medical  opinions  and  pro- 
cedure, and  weighing  them  by  his  own  experience 
and  observation,  turn  out  work  that  was  valuable 
for  all  succeeding  generations.  The  modern  Ger- 
man school  of  medical  historians  have  agreed  in 
declaring  him  an  independent  thinker  and  physician, 


40  OLD-TIME  MAKERS  OF  MEDICINE 

who  represents  a  distinct  link  in  medical  tradition. 

He  came  of  a  distinguished  family,  in  which  the 
following  of  medicine  as  a  profession  might  be 
looked  upon  as  hereditary.  His  father  was  a  physi- 
cian, and  it  is  probable  that  there  were  physicians 
in  preceding  generations,  and  one  of  his  brothers, 
Dioscoros,  was  also  a  successful  physician.  Alto- 
gether four  of  his  brothers  reached  such  distinction 
in  their  life  work  that  their  names  have  come  down 
to  us  through  nearly  fifteen  hundred  years.  The 
eldest  of  them  was  Anthemios,  the  builder  of  the 
great  church  of  Santa  Sophia  in  Constantinople. 
As  this  is  one  of  the  world's  great  churches,  and 
still  stands  for  the  admiration  of  men  a  millennium 
and  a  half  after  its  completion,  it  is  easy  to  under- 
stand that  Anthemios'  reputation  is  well  founded. 
A  second  brother  was  Metrodoros,  a  distinguished 
grammarian  and  teacher,  especially  of  the  youthful 
nobility  of  Byzantium,  as  it  was  then  called,  or  Con- 
stantinople, as  we  have  come  to  call  it.  A  third 
brother  was  a  prominent  jurist,  also  in  Constan- 
tinople. The  fourth  brother,  Dioscoros,  like  Alex- 
ander, a  physician,  remained  in  his  birthplace, 
Tralles,  and  acquired  there  a  great  practice. 

It  was  with  his  father  at  Tralles  that  Alexander 
received  his  early  medical  training.  The  father  of 
a  friend  and  colleague,  Cosmas,  who  later  dedicated 
a  book  to  Alexander,  was  also  his  teacher,  while  he 
was  in  his  native  city.  As  a  young  man,  Alexander 
undertook  extensive  travels,  which  led  him  into 
Italy,  Gaul,  Spain,  and  Africa,  everywhere  gather- 
ing medical  knowledge  and  medical  experience. 
Then  he  settled  down  at  Rome,  probably  in  an  official 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   41 

position,  and  practised  medicine  successfully  until 
a  very  old  age.  He  was  probably  eighty  years  of 
age  when,  some  time  during  the  first  decade  of  the 
seventh  century,  he  died. 

Puschmann,  who  has  made  a  special  study  of 
Alexander's  life  and  work,  suggests  that  since  some 
of  his  books  have  the  form  of  academic  lectures  he 
was  probably  a  teacher  of  medicine  at  Rome.  As 
might  be  expected  from  what  we  know  of  the  rela- 
tions of  the  rest  of  the  family  to  the  nobility  of  the 
time,  it  is  easy  to  understand,  especially  in  connec- 
tion with  hints  in  Alexander's  favorite  modes  of 
therapeutics,  that  costliness  of  remedies  made  no 
difference  to  his  patients,  that  he  must  have  had  the 
treatment  of  some  of  the  wealthiest  families  in 
Rome. 

His  principal  work  is  a  Treatise  on  the  Pathology 
and  Therapeutics  of  Internal  Diseases,  in  twelve 
books.  The  first  eleven  books  were  evidently 
material  gathered  for  lectures  or  teaching  of  some 
kind.  The  twelfth  book,  in  which  considerable  use 
of  Aetius'  writings  is  made,  was  written,  according 
to  Puschmann,  toward  the  end  of  Alexander's  life, 
and  was  meant  to  contain  supplementary  matter, 
comprising  especially  his  views  gathered  from  ob- 
servation as  to  the  pathology  of  internal  diseases. 
A  shorter  treatise  of  Alexander  is  with  regard  to 
intestinal  parasites.  There  are  many  printed  edi- 
tions of  these  books,  and  many  manuscript  copies 
are  in  existence.  Alexander  was  often  quoted  dur- 
ing the  Middle  Ages,  and  in  recent  years,  with  the 
growth  of  our  knowledge  of  medical  history,  he  has 
come  to  be  a  favorite  subject  of  study. 


42  OLD-TIME  MAKERS  OF  MEDICINE 

Alexander's  first  book  of  pathology  and  thera- 
peutics treats  of  head  and  brain  diseases.  For  bald- 
ness, the  first  symptom  of  which  is  falling  out  of 
the  hair,  he  counsels  cutting  the  hair  short,  washing 
the  scalp  vigorously,  and  the  rubbing  in  of  sulphur 
ointments.  For  grey  hair  he  suggests  certain  hair 
dyes,  as  nutgalls,  red  wine,  and  so  forth.  For 
dandruff,  which  he  described  as  the  excessive  forma- 
tion of  small  flake-like  scales,  he  recommends  rub- 
bing with  wine,  with  certain  salves,  and  washing  with 
salt  water. 

He  gives  a  good  deal  of  attention  to  diseases  of 
t  the  nervous  system.  He  has  a  rather  interesting 
chapter  on  headache.  The  affection  occurs  in  con- 
nection with  fevers,  after  excess  in  drinking,,  and  as 
a  consequence  of  injury  to  the  skull.  Besides,  it 
V  develops  as  a  result  of  disturbances  of  the  natural 
processes  in  the  head,  the  stomach,  the  liver,  and 
the  spleen.  Headache,  as  the  first  symptom  of  in- 
flammation of  the  brain,  is  often  the  forerunner  of 
convulsions,  delirium,  and  sudden  death.  Chronic 
or  recurrent  headache  occurs  in  connection  with 
plethora,  diseases  of  the  brain,  biliousness,  digestive 
disturbances,  insomnia,  and  continued  worry. 
Hemicrania  has  its  origin  in  the  brain,  because  of 
the  presence  of  toxic  materials,  and  specially  their 
transformation  into  gaseous  substances.  It  also 
occurs  in  connection  with  abdominal  affections.  This 
latter  remark  particularly  is  directed  to  the  cases 
which  occur  in  women. 

For  apoplexy  and  the  consequent  paralysis,  Alex- 
ander considered  venesection  the  best  remedy. 
Massage,  rubbings,  baths,  and  warm  applications 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   43 

are  recommended  for  the  paralytic  conditions.  He 
had  evidently  had  considerable  experience  with 
epilepsy.  It  develops  either  from  injuries  of  the 
head  or  from  disturbances  of  the  stomach,  or  oc- 
casionally other  parts  of  the  body.  When  it  occurs 
in  nursing  infants,  nourishment  is  the  best  remedy, 
and  he  gives  detailed  directions  for  the  selection  of 
a  wet  nurse,  and  very  careful  directions  as  to  her 
mode  of  life.  He  emphasizes  very  much  the  neces- 
sity for  careful  attention  to  the  gastro-intestinal 
tract  in  many  cases  of  epilepsyj  Planned  diet  and 
regular  bowels  are  very  helpful.  He  rejects  treat- 
ment of  the  condition  by  surgery  of  the  head,  either 
by  trephining  or  by  incisions,  or  cauterization.  Keg- 
ular  exercise,  baths,  sexual  abstinence  are  the 
foundation  of  any  successful  treatment.  It  is  prob- 
able  that  we  have  returned  to  Alexander's  treat- 
ment of  epilepsy  much  more  nearly  than  is  generally 
thought.  There  are  those  who  still  think  that  rem- 
edies of  various  kinds  do  good,  but  in  the  large 
epileptic  colonies  regular  exercise,  bland  diet,  reg- 
ulation of  the  bowels,  and  avoidance  of  excesses  of 
all  kinds,  with  occupation  of  mind,  constitute  the 
mainstay  of  their  treatment. 

Alexander  has  much  to  say  with  regard  to  phre- 
nitis,  a  febrile  condition  complicated  by  delirium, 
which,  following  Galen,  he  considers  an  affection  of 
the  brain.  It  is  evidently  the  brain  fever  of  the 
generations  preceding  the  last,  an  important  element 
of  which  was  made  up  of  the  infectious  meningitises. 
Alexander  suggests  its  treatment  by  opiates  after 
preliminary  venesection,  rubbings,  lukewarm  baths, 
and  stimulating  drinks.    Every  disturbance  of  the 


44  OLD-TIME  MAKERS  OF  MEDICINE 

patient  must  be  avoided,  and  visitors  must  be  for- 
bidden. The  patient's  room  should  rather  be  light 
than  dark.  His  teaching  crops  up  constantly  in  the 
centuries  after  his  time,  until  the  end  of  the  nine- 
teenth century,  and  while  we  now  understand  the 
causes  of  the  condition  better,  we  can  do  little  more 
for  it  than  he  did. 

Alexander  divided  mental  diseases  into  two,  the 
maniacal  and  melancholic.  Mania  was,  however, 
really  a  further  development  of  melancholia,  and 
represented  a  high  grade  of  insanity.  Under  melan- 
choly he  groups  not  only  what  we  denominate  by 
that  term,  but  also  all  depressed  conditions,  and 
the  paranoias,  as  also  many  cases  of  imbecility. 
The  cause  of  mental  diseases  was  to  be  found  in  the 
blood.  He  counselled  the  use  of  venesection,  of  lax- 
atives and  purgatives,  of  baths  and  stimulant  rem- 
edies. He  insisted  very  much,  however,  on  mental 
influence  in  the  disease,  on  change  of  place  and  air, 
visits  to  the  theatre,  and  every  possible  form  of 
mental  diversion,  as  among  the  best  remedial 
measures. 

After  his  book  on  diseases  of  the  head,  his  most 
important  section  is  on  diseases  of  the  respiratory 
system.  In  this  he  treats  first  of  angina,  and  recom- 
mends as  gargles  at  the  beginning  light  astringents ; 
later  stronger  astringents,  as  alum  and  soda  dis- 
solved in  warm  water,  should  be  employed.  Warm 
compresses,  venesection  from  the  sublingual  veins, 
and  from  the  jugular,  and  purgatives  in  severe 
cases,  are  the  further  remedies.  He  treats  of  cough 
as  a  symptom  due  to  hot  or  cold,  dry  or  wet  dys- 
crasias.     Opium  preparations  carefully  used  are  the 


GEE  AT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   45 

best  remedies.  The  breathing  in  of  steam  impreg- 
nated with  various  ethereal  resins,  was  also  recom- 
mended. 

He  gives  a  rather  interestingly  modern  treatment 
of  consumption.  He  recommends  an  abundance  of 
milk  with  a  strong  nutritious  diet,  as  digestible  as 
possible.  A  good  auxiliary  to  this  treatment  was 
change  of  air,  a  sea  voyage,  and  a  stay  at  a  water- 
ing-place. Asses'  and  mares'  milk  are  much  better 
for  these  patients  than  cows '  and  goats '  milk.  There 
is  not  enough  difference  in  the  composition  of  these 
various  milks  to  make  their  special  consumption  of 
import,|  but  it  is  probable  that  the  suggestive  in- 
fluence of  the  taking  of  an  unusual  milk  had  a  very 
favorable  effect  upon  patients,  and  this  effect  was 
renewed  frequently,  so  that  much  good  was 
ultimately  accomplished.  1  For  hemoptysis,  espe- 
cially when  it  was  acute"  and  due  as  Alexander 
thought  to  the  rupture  of  a  blood  vessel  in  the  lungs, 
he  recommended  the opening  of  a  vein  at  the  elbow 
or  the  ankle— in  order  to  divert  the  blood  from  the 
place  of  rupture  to  the  healthy  parts  of  the  circula- 
tion. He  insisted  that  the  patients  must  rest,  that 
they  should  take  acid  and  astringent  drinks,  that 
cold  compresses  should  be  placed  upon  the  chest 
(our  ice  bags),  and  that  they  should  take  only  a 
liquid  diet  at  most  lukewarm,  or,  better,  if  agree- 
able to  them,  cold.  When  the  bleeding  stopped,  a 
milk  cure  was  very  useful  for  the  restoration  of 
these^patients  to  strength. 

It  is  not  surprising,  then,  to  find  that  Alexander 
suggests  a  thoroughly  rational  treatment  for 
pleurisy.    He  recognizes  this  as  an  inflammation 


46  OLD-TIME  MAKERS  OF  MEDICINE 

of  the  membrane  covering  the  ribs,  and  its  symp- 
toms are  severe  pain,  disturbance  of  breathing,  and 
coughing.  In  certain  cases  there  is  severe  fever, 
and  Alexander  knows  of  purulent  pleurisy,  and  the 
fact  that  when  pus  is  present  the  side  on  which  it 
is  is  warmer  than  the  other.  Pleurisy  can  be,  he 
says,  rather  easily  confounded  with  certain  liver 
affections,  but  there  is  a  peculiar  hardness  of  the 
pulse  characteristic  of  pleurisy,  and  there  is  no  ex- 
pectoration in  liver  cases,  though  it  also  may  be  ab- 
sent in  many  cases  of  pleurisy.  Sufferers  from 
liver  disease  usually  have  a  paler  color  than 
pleuritics.  His  treatment  consists  in  venesection, 
purgatives,  and,  when  pus  is  formed,  local  incision. 
He  recommends  the  laying  on  of  sponges  dipped 
in  warm  water,  and  the  internal  use  of  honey  lem- 
onade. Opium  should  not  be  used  unless  the  patient 
suffers  from  sleeplessness. 

Some  of  the  general  principles  of  therapeutics 
that  Alexander  lays  down  are  very  interesting,  even 
from  our  modern  standpoint.  Trust  should  not  be 
placed  in  any  single  method  of  treatment.  Every 
available  means  of  bringing  relief  to  the  patient 
should  be  tried.  "  The  duty  of  the  physician  is  to 
cool  what  is  hot,  to  warm  what  is  cold,  to  dry  what 
is  moist,  and  to  moisten  what  is  dry.  He  should 
look  upon  the  patient  as  a  besieged  city,  and  try  to 
rescue  him  with  every  means  that  art  and  science 
places  at  his  command.  The  physician  should  be  an 
inventor,  and  think  out  new  ways  and  means  by 
which  the  cure  of  the  patient's  affection  and  the 
relief  of  his  symptoms  may  be  brought  about. '  ■  The 
most  important  factor  in  his  therapeutics  is  diet. 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES  47 

Watering-places  and  various  forms  of  mineral 
waters,  as  well  as  warm  baths  and  sea  baths,  are 
constantly  recommended  by  him.  He  took  strong 
ground  against  the  use  of  many  drugs,  and  the  rage 
for  operating.  The  prophylaxis  of  disease  is  in 
Alexander's  opinion  the  important  part  of  the 
physician's  duty.  His  treatment  of  fever  shows  the 
application  of  his  principle:  cold  baths,  cold  com- 
presses, and  a  cooling  diet,  were  his  favorite  rem- 
edies. He  encouraged  diaphoresis  nearly  always, 
and  gave  wine  and  stimulating  drugs  only  when  the 
patient  was  very  weak.  He  differentiates  two  kinds 
of  quartan  fever.  One  of  these  he  attributes  to  an 
affection  of  the  spleen,  because  he  had  noticed  that 
the  spleen  was  enlarged  during  it,  and  that,  after 
purgation,  the  enlarged  spleen  decreased  in  size. 

Alexander  was  a  strong  opponent  of  drastic  rem- 
edies of  all  kinds.  He  did  not  believe  in  strong 
purgatives,  nor  in  profuse  and  sudden  blood-let- 
tings. He  opposed  arteriotomy  for  this  reason,  and 
refused  to  employ  extensive  cauterization.  His 
diagnosis  is  thorough  and  careful.  He  insisted  par- 
ticularly on  inspection  and  palpation  of  the  whole 
body;  on  careful  examination  of  the  urine,  of  the 
feces,  and  the  sputum;  on  study  of  the  pulse  and 
the  breathing.  He  thought  that  a  great  deal  might 
be  learned  from  the  patient's  history.  The  general 
constitution  is  also  of  importance.  His  therapeutics 
is,  above  all,  individual.  Remedies  must  be  admin- 
istered with  careful  reference  to  the  constitution, 
the  age,  the  sex,  and  the  condition  of  the  patient's 
strength.  Special  attention  must  always  be  paid 
to  nature's  efforts  to  cure,  and  these  must  be  en- 


48  OLD-TIME  MAKERS  OF  MEDICINE 

couraged  as  far  as  possible.  Alexander  had  no 
sympathy  at  all  with  the  idea  that  remedies  must 
work  against  nature.  His  position  in  this  matter 
places  him  among  the  dozen  men  whose  name  and 
writings  have  given  them  an  enduring  place  in  the 
favor  of  the  profession  at  all  times,  when  we  were 
not  being  carried  away  by  some  therapeutic  fad  or 
imagining  that  some  new  theory  solved  the  whole 
problem  of  the  causation  and  cure  of  disease. 

Gurlt,  in  his  "  History  of  Surgery,"  has  ab- 
stracted from  Alexander  particularly  certain  phases 
of  what  the  Germans  call  external  pathology  and 
therapeutics.  For  instance,  Alexander's  treatment 
of  troubles  connected  with  the  ear  is  very  interest- 
ing. Gurlt  declares  that  this  chapter  alone  provides 
striking  evidence  for  Alexander's  practical  experi- 
ence and  power  of  observation,  as  well  as  for  his 
knowledge  of  the  literature  of  medicine.  He  con- 
siders that  only  a  short  abstract  is  needed  to  show 
that. 

For  water  that  has  found  its  way  into  the  external 
ear,  Alexander  suggests  a  mode  of  treatment  that  is 
still  popularly  used.  The  patient  should  stand  upon 
the  leg  corresponding  to  the  side  on  which  there  is 
water  in  his  ear,  and  then,  with  head  leaning  to  that 
side,  should  hop  or  kick  out  with  the  other  leg.  The 
water  may  be  drawn  out  by  means  of  suction 
through  a  reed.  In  order  to  get  foreign  bodies  out 
of  the  external  auditory  canal,  an  ear  spoon  or  other 
small  instrument  should  be  wrapped  in  wool  and 
dipped  in  turpentine,  or  some  other  sticky  material. 
Occasionally  he  has  seen  sneezing,  especially  if  the 
mouth  and  nose  are  covered  with  a  cloth,  and  the 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES  49 

head  leant  toward  the  affected  side,  bring  about  a 
dislodgrnent  of  the  foreign  body.  If  these  means  do 
not  succeed,  gentle  injections  of  warm  oil  or  wash- 
ing out  of  the  canal  with  honey  water  should  be 
tried.  Foreign  bodies  may  also  be  removed  by 
means  of  suction.  Insects  or  worms  that  find  their 
way  into  the  ear  may  be  killed  by  injections  of  acid 
and  oil,  or  other  substances. 

Gurlt  also  calls  attention  to  Alexander's  careful 
differentiation  of  certain  very  dangerous  forms  of 
inflammation  of  the  throat  from  others  which  are 
rather  readily  treated.  He  says,  "  Inflammation  of 
the  throat  may,  under  certain  circumstances,  belong 
to  the  severest  diseases.  The  patients  succumb  to 
it  as  a  consequence  of  suffocation,  just  as  if  they 
were  choked  or  hanged.  For  this  reason,  perhaps, 
the  affection  bears  the  name  synanche,  which  means 
constriction."  He  then  points  out  various  other 
forms  of  inflammation  of  the  throat,  acute  and 
chronic,  suggesting  various  names  and  the  differ- 
ential diagnostic  signs. 

One  of  the  most  surprising  chapters  of  Alexan- 
der's knowledge  of  pathology  and  therapeutics  is 
to  be  found  in  his  treatment  of  the  subject  of  in- 
testinal worms,  which  is  contained  in  a  letter  sent 
by  him  to  his  friend,  Theodore,  whose  child  was  suf- 
fering from  them.  He  describes  the  oxyuris  ver- 
micularis  with  knowledge  manifestly  derived  from 
personal  observation.  He  dwells  on  the  itching  in 
the  region  of  the  anus,  caused  by  the  oxyuris,  and 
the  fact  that  they  probably  find  their  way  into  the 
upper  part  of  the  digestive  tract  because  of  the 
soiling  of  the  hands.    He  knew  that  the  tapeworms 


50  OLD-TIME  MAKERS  OF  MEDICINE 

often  reached  great  length, — he  has  seen  one  over 
sixteen  feet  long, — and  also  that  they  had  a  life  cycle, 
so  that  they  existed  in  two  different  forms.  He  de- 
scribes the  roundworms  as  existing  in  the  intestines, 
bnt  occasionally  wandering  into  the  stomach  to  be 
vomited.  His  vermifuges  were  the  flowers  and  the 
seeds  of  the  pomegranate,  the  seeds  of  the  helio- 
trope, castor-oil,  and  certain  herbs  that  are  still 
used,  by  country  people,  at  least,  as  worm  medicines. 
For  roundworms  he  recommended  especially  a  de- 
coction of  artemisia  maritima,  coriander  seeds,  and 
decoctions  of  thyme.  Our  return  to  ihympl  for  in- 
testinal parasites  is  interesting.  For  the  oxyuris 
he  prescribed  clysters  of  ethereal  oils.  We  have 
not  advanced  much  in  our  treatment  of  intestinal 
worms  in  the  fifteen  hundred  years  since  Alexan- 
der's time. 

PAUL  or  ^IGINA 

Another  extremely  important  writer  in  these  early 
medieval  times,  whose  opportunities  for  study  in 
medicine  and  for  the  practice  of  it,  were  afforded 
him  by  Christian  schools  and  Christian  hospitals, 
was  Paul  of  JEgina,  He  was  born  on  the  island  of 
.ZEgina,  hence  the  name  .iE'ginetus,  by  which  he  is 
commonly  known.  There  used  to  be  considerable 
doubt  as  to  just  when  Paul  lived,  and  dates  for  his 
career  were  placed  as  widely  apart  as  the  fifth  and 
the  seventh  centuries.  We  know  that  he  was  edu- 
cated at  the  University  of  Alexandria.  As  that  in- 
stitution was  broken  up  at  the  time  of  the  capture 
of  the  city  by  the  Arabs,  he  cannot  have  been  there 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES    51 

later  than  during  the  first  half  of  the  seventh  cen- 
tury. An  Arabian  writer,  Abul  Farag,  in  "  The 
Story  of  the  Reign  of  the  Emperor  Heraclius,"  who 
died  641,  says  that  "  among  the  celebrated  physi- 
cians who  flourished  at  this  time  was  Paulus 
iEginetus."  In  his  works  Paul  quotes  from  Alex- 
ander of  Tralles,  so  that  there  seems  to  be  no  doubt 
now  that  his  life  must  be  placed  in  the  seventh 
century. 

The  most  important  portion  of  Paul's  work  for 
the  modern  time  is  contained  in  his  sixth  book  on 
surgery.  In  this  his  personal  observations  are 
especially  accumulated.  Gurlt  has  reviewed  it  at 
considerable  length,  devoting  altogether  nearly 
thirty  pages  to  it,  and  it  well  deserves  this  lengthy 
abstract.  Paul  quotes  a  great  many  of  the  writers 
on  surgery  before  his  time,  and  then  adds  the  re- 
sults of  his  own  observation  and  experience.  In 
it  one  finds  careful  detailed  descriptions  of  many 
operations  that  are  usually  supposed  to  be  modern. 
Very  probably  the  description  quoted  by  Gurlt  of 
the  method  of  treating  fishbones  that  have  become 
caught  in  the  throat  will  give  the  best  idea  of  how 
thoroughly  practical  Paul  is  in  his  directions.  He 
says :  "  It  will  often  happen  in  eating  that  fish- 
bones or  other  objects  may  be  swallowed  and  get 
caught  in  some  part  of  the  throat.  If  they  can  be 
seen  they  should  be  removed  with  the  forceps  de- 
signed for  that  purpose.  Where  they  are  deeper, 
some  recommend  that  the  patient  should  swallow 
large  mouthfuls  of  bread  or  other  such  food.  Others 
recommend  that  a  clean  soft  sponge  of  small  circum- 
ference to  which  a  string  is  attached  be  swallowed, 


52  OLD-TIME  MAKERS  OF  MEDICINE 

and  then  drawn  out  by  means  of  the  string.  This 
should  be  repeated  until  the  bone  or  other  object 
gets  caught  in  the  sponge  and  is  drawn  out.  If  the 
patient  is  seen  immediately  after  eating,  and  the 
swallowed  object  is  not  visible,  vomiting  should  be 
brought  on  by  means  of  a  finger  in  the  throat  or 
irritation  with  the  feather,  and  then  not  infrequently 
the  swallowed  object  will  be  brought  up  with  the 
vomit. ' ' 

In  the  chapter  immediately  following  this, 
XXXIII,  there  is  a  description  of  the  method  of 
opening  the  larynx  or  the  trachea,  with  the  indica- 
tions for  this  operation.  The  surgeon  will  know 
that  he  has  opened  the  trachea  when  the  air  streams 
out  of  the  wound  with  some  force,  and  the  voice  is 
lost.  As  soon  as  the  danger  of  suffocation  is  over, 
the  edges  of  the  wound  should  be  freshened  and  the 
skin  surfaces  brought  together  with  sutures.  Only 
the  skin  without  the  cartilage  should  be  sutured, 
and  general  treatment  for  encouraging  union  should 
be  employed.  If  the  wound  fails  to  heal  immedi- 
ately, a  treatment  calculated  to  encourage  granula- 
tions should  be  undertaken.  This  same  method  of 
treatment  will  be  of  service  whenever  we  happen  to 
have  a  patient  who,  in  order  to  commit  suicide,  has 
cut  his  throat.  Paul's  exact  term  is,  perhaps,  best 
translated  by  the  expression,  slashed  his  larynx. 

One  of  the  features  of  Paul's  "  Treatise  on  Sur- 
gery "  is  his  description  of  a  radical  operation  for 
hernia.  He  describes  scrotal  hernia  under  the  name 
enterocele,  and  says  that  it  is  due  either  to  a  tearing 
or  a  stretching  of  the  peritoneum.  It  may  be  the 
consequence  either  of  injury  or  of  violent  efforts, 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES    53 

made  during  crying.  When  the  scrotum  contains 
only  omentum,  he  calls  the  condition  epiplocele; 
when  it  also  contains  intestine,  an  epiplo-enterocele. 
Hernia  that  does  not  descend  into  the  scrotum  he 
calls  bubonocele.  For  operation  the  patient  should 
be  placed  on  the  back,  and,  the  skin  of  the  inguinal 
region  being  stretched  by  an  assistant,  an  oblique 
incision  in  the  direction  in  which  the  blood  vessels 
run  should  be  made.  The  incision  should  then  be 
stretched  by  means  of  retractors,  until  the  contents 
of  the  sac  can  be  lifted  out.  All  adhesions  should 
be  broken  up  and  the  fat  be  removed,  and  the  hernia 
replaced  within  the  abdomen.  Care  should  be  taken 
that  no  loop  of  intestine  is  allowed  to  remain.  Then 
a  large  needle  with  double  thread  made  of  ten 
strands  should  be  run  through  the  middle  of  the  in- 
cision in  the  end  of  the  peritoneum,  and  tied  firmly 
in  cross  sutures.  The  outer  structures  should  be 
brought  together  with  a  second  ligature,  and  the 
lower  end  of  the  incision  should  have  a  wick  placed  in 
it  for  drainage,  and  the  site  of  operation  should  be 
covered  with  an  oil  bandage. 

The  Arab  writer,  Abul  Farag,  to  whose  references 
we  owe  the  definite  placing  of  the  time  when  Paul 
lived,  said  that  "  he  had  special  experience  in 
women's  diseases,  and  had  devoted  himself  to  them 
with  great  industry  and  success.  The  midwives  of 
the  time  were  accustomed  to  go  to  him  and  ask  his 
counsel  with  regard  to  accidents  that  happen  during 
and  after  parturition.  He  willingly  imparted  his 
information,  and  told  them  what  they  should  do. 
For  this  reason  he  came  to  be  known  as  the  Ob- 
stetrician. ' '    Perhaps  the  term  should  be  translated 


54  OLD-TIME  MAKEBS  OF  MEDICINE 

the  man-midwife,  for  it  was  rather  unusual  for  men 
to  have  much  knowledge  of  this  subject.  His  knowl- 
edge of  the  phenomena  of  menstruation  was  as  wide 
and  definite.  He  knew  a  great  deal  of  how  to  treat 
its  disturbances.  He  seems  to  have  been  the  first 
one  to  suggest  that  in  metrorrhagia,  with  severe 
hemorrhage  from  the  uterus,  the  bleeding  might  be 
stopped  by  putting  ligatures  around  the  limbs.  This 
same  method  has  been  suggested  for  severe 
hemorrhage  from  the  lungs  as  well  as  from  the 
uterus  in  our  own  time.  In  hysteria  he  also  sug- 
gested ligature  of  the  limbs,  and  it  is  easy  to  under- 
stand that  this  might  be  a  very  strongly  suggestive 
treatment  for  the  severer  forms  of  hysteria.  It  is 
possible,  too,  that  the  modification  of  the  circulation 
to  the  nervous  system  induced  by  the  shutting  off 
of  the  circulation  in  large  areas  of  the  body  might 
very  well  have  a  favorable  physical  effect  in  this  af- 
fection. Paul's  description  of  the  use  of  the  spec- 
ulum is  as  complete  as  that  in  any  modern  text- 
book of  gynaecology. 

FURTHER  CHRISTIAN  PHYSICIANS 

Another  distinguished  Christian  medical  scientist 
was  Theophilus  Protosbatharius,  who  belonged  to 
the  court  of  the  Greek  Emperor  Heraclius,  in  the 
seventh  century.  He  seems  to  have  had  a  life  very 
full  of  interest  and  surprisingly  varied  duties.  He 
was  a  bishop,  and,  at  the  same  time,  commander  of 
the  imperial  bodyguard,  and  the  author  of  a  little 
work  on  the  fabric  of  the  human  body.  The  most 
surprising  chapter  in  the  history  of  the  book  is 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES   55 

that  for  some  two  centuries,  in  quite  modern  times, 
it  was  used  as  a  text-book  of  anatomy  at  the  Uni- 
versity of  Paris.  -It  was  printed  in  a  number  of 
editions  early  in  the  history  of  printing,  at  least 
one  very  probably  before  1500,  and  several  later. 

There  are  very  interesting  phases  of  medicine  de- 
lightfully surprising  in  their  modernity  to  be  found 
here  and  there  in  many  of  these  early  Christian 
writers  on  medicine.  For  instance,  in  a  compend 
of  medicine  written  by  one  Leo,  who,  under  the  Em- 
peror Theophilus,  seems  to  have  been  a  prominent 
physician  of  Byzantium  (the  compend  was  written 
for  a  young  physician  just  beginning  practice),  we 
find  the  following  classification  of  hydrops  or  ab- 
dominal dilatation :  i4  There  are  three  kinds ;  the  first 
is  ascites,  due  to  the  presence  of  watery  fluid,  for 
which  we  do  paracentesis;  second,  tympany,  when 
the  abdomen  is  swollen  from  the  presence  of  air  or 
gas.  This  may  be  differentiated  by  percussion  of 
the  belly.  When  air  is  present  the  sound  given 
forth  is  like  that  of  a  drum,  while  in  the  first  form 
ascites  the  sound  is  like  that  from  a  sack  [the  word 
used  is  the  same  as  for  a  wine  sack] ;  the  third  form 
is  called  anasarca,  when  the  whole  body  swells." 

It  has  often  been  the  subject  of  misunderstanding 
as  to  why  medicine  should  have  developed  among  the 
Latin  Christian  nations  so  much  more  slowly  than 
among  the  Arabs  during  the  early  Middle  Ages. 
Anyone  who  knows  the  conditions  in  which  Chris- 
tianity came  into  existence  in  Italy  will  not  be  sur- 
prised at  that.  The  Arabs  in  the  East  were  in  con- 
tact with  Greek  thought,  and  that  is  eminently 
prolific  and  inspiring.  At  the  most,  the  Christians  in 


56  OLD-TIME  MAKERS  OF  MEDICINE 

Italy  got  their  inspiration  at  second  hand  through 
the  Romans.  The  Romans  themselves,  in  spite  of  in- 
timate contact  with  Greek  physicians,  never  made 
any  important  contributions  to  medical  science,  nor 
to  science  of  any  kind.  Their  successors,  the  Chris- 
tians of  Rome  and  Italy,  then  could  scarcely  be  ex- 
pected to  do  better,  hampered  especially,  as  they 
were,  by  the  trying  social  conditions  created  by  the 
invasion  of  the  barbarians  from  the  North.  When- 
ever the  Christians  were  in  contact  with  Greek 
thought  and  Greek  medicine,  above  all,  as  at  Alex- 
andria, or  in  certain  of  the  cities  of  the  near  East, 
we  have  distinguished  contributions  from  them. 

AKABIAN  CHKISTIAN  PHYSICIANS 

That  this  is  not  a  partial  view  suggested  by  the 
desire  to  make  out  a  better  case  for  Christianity  in 
its  relation  to  science  will  be  very  well  understood, 
besides,  from  the  fact  that  a  number  of  the  original 
physicians  of  Arab  stock  who  attracted  attention 
during  the  first  period  of  Arabian  medicine,  that  is, 
during  the  eighth  and  ninth  centuries,  were  Chris- 
tians. There  are  a  series  of  physicians  belonging 
to  the  Christian  family  Bachtischua,  a  name  which 
is  derived  from  Bocht  Jesu,  that  is,  servant  of 
Jesus,  who,  from  the  middle  of  the  eighth  to  the 
middle  of  the  eleventh  century,  acquired  great  fame. 
The  first  of  them,  George  (Dschordschis),  after  ac- 
quiring fame  elsewhere,  was  called  to  Bagdad  by 
the  Caliph  El-Mansur,  where,  because  of  his  med- 
ical skill,  he  reached  the  highest  honors.  His  son 
became  the  body-physician   of  Harun   al-Raschid. 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES    57 

In  the  third  generation  Gabriel  (Dschibril)  acquired 
fame  and  did  much,  as  had  his  father  and  grand- 
father, for  the  medicine  of  the  time,  by  translations 
of  the  Greek  physicians  into  Arabian. 

These  men  may  well  be  said  to  have  introduced 
Greek  medicine  to  the  Mohammedans.  It  was  their 
teaching  that  aroused  Moslem  scholars  from  the 
apathy  that  had  characterized  the  attitude  of  the 
Arabian  people  toward  science  at  the  beginning  of 
Mohammedanism.  As  time  went  on,  other  great 
Christian  medical  teachers  distinguished  them- 
selves among  the  Arabs.  Of  these  the  most  prom- 
inent was  Messui  the  elder,  who  is  also  known  as 
Janus  Damascenus.  Both  he  and  his  father  prac- 
tised medicine  with  great  success  in  Bagdad,  and  his 
son  became  the  body-physician  to  Harun  al-Easchid 
either  after  or  in  conjunction  with  Gabriel  Bach- 
tischua.  Like  his  colleague  or  predecessor  in  of- 
ficial position,  he,  too,  made  translations  from  the 
Greek  into  Arabic.  Another  distinguished  Arabian 
Christian  physician  was  Serapion  the  elder.  He 
was  born  in  Damascus,  and  flourished  about  the 
middle  of  the  ninth  century.  He  wrote  a  book  on 
medicine  called  the  "  Aggregator, ' '  or  "  Brevi- 
arium,"  or  "  Practica  Medicine,"  which  appeared 
in  many  printed  editions  within  the  century  after 
the  invention  of  printing.  During  the  ninth  cen- 
tury, also,  we  have  an  account  of  Honein  Ben  Ischak, 
who  is  known  in  the  West  as  Johannitius.  After 
travelling  much,  especially  in  Greece  and  Persia, 
he  settled  in  Bagdad,  and,  under  the  patronage  of 
the  Caliph  Mamum,  made  many  translations.  He 
translated  most  of  the  old  Greek  medical  writers, 


58  OLD-TIME  MAKERS  OF  MEDICINE 

and  also  certain  of  the  Greek  philosophic  and  mathe- 
matical works.  The  accuracy  of  his  translations 
became  a  proverb.  His  compendium  of  Galen  was 
the  text-book  of  medicine  in  the  West  for  many  cen- 
turies. It  was  known  as  the  "  Isagoge  in  Artem 
Parvam  Galeni."  His  son,  Ishac  Ben  Honein,  and 
his  nephew,  Hobeisch,  were  also  famous  as  medical 
practitioners  and  translators. 

Still  another  of  these  Arabian  Christians,  who 
acquired  a  reputation  as  writers  in  medicine,  was 
Alkindus.  He  wrote  with  regard  to  nearly  every- 
thing, however,  and  so  came  to  be  called  the  philoso- 
pher. He  is  said  altogether  to  have  written  and 
translated  about  two  hundred  works,  of  which 
twenty-two  treat  of  medicine.  He  was  a  contem- 
porary of  Honein  Ben  Ischak  in  the  ninth  century. 
Another  of  the  great  ninth-century  Christian  physi- 
cians and  translators  from  the  Greek  was  Kostaben 
Luka.  He  was  of  Greek  origin,  but  lived  in 
Armenia  and  made  translations  from  Greek  into 
Arabic.  Nearly  all  of  these  men  took  not  alone 
medical  science,  but  the  whole  round  of  physical 
science,  for  their  special  subject.  A  typical  example 
in  the  ninth  century  was  Abuhassan  Ben  Korra, 
many  of  whose  family  during  succeeding  genera- 
tions attracted  attention  as  scholars.  He  became 
the  astronomer  and  physician  of  the  Caliph  Mo- 
tadhid.  His  translations  in  medical  literature  were 
mainly  excerpts  from  Hippocrates  and  Galen  meant 
for  popular  use.  These  Christian  translators,  thor- 
oughly scientific  as  far  as  their  times  permitted 
them  to  be,  were  wonderfully  industrious  in  their 
work  as  translators,  great  teachers  in  every  sense 


GREAT  PHYSICIANS  IN  EARLY  CHRISTIAN  TIMES    59 

of  the  word,  and  they  are  the  men  who  formed  the 
traditions  on  which  the  greater  Arabian  physicians 
from  Rhazes  onward  were  educated. 

It  would  be  easy  to  think  that  these  men,  oc- 
cupied so  much  with  translations,  and  intent  on  the 
re-introduction  of  Greek  medicine,  might  have  de- 
pended very  little  on  their  own  observations,  and 
been  very  impractical.  All  that  is  needed  to  coun- 
teract any  such  false  impression,  however,  is  to 
know  something  definite  about  their  books.  Grurlt, 
in  his  "  History  of  Surgery,' '  has  some  quotations 
from  Serapion  the  elder,  who  is  often  quoted  by 
Rhazes.  In  the  treatment  of  hemorrhoids  Sera- 
pion advises  ligature  and  insists  that  they  must  be 
tied  with  a  silk  thread  or  with  some  other  strong 
thread,  and  then  relief  will  come.  He  says  some 
people  burn  them  medicinis  acutis  (touching 
with  acids,  as  some  do  even  yet),  and  some  incise 
them  with  a  knife.  He  prefers  the  ligature,  how- 
ever. He  calmly  discusses  the  removal  of  stones 
from  the  kidney  by  incision  of  the  pelvis  of  the 
kidney  through  an  opening  in  the  loin.  He  con- 
siders the  operation  very  dangerous,  however,  but 
seems  to  think  the  removal  of  a  stone  from  the 
bladder  a  rather  simple  procedure.  His  descrip- 
tion of  the  technique  of  the  use  of  a  catheter  and 
of  a  stylet  with  it,  and  apparently  also  of  a  guide 
for  it  in  difficult  cases,  is  extremely  interesting. 
He  suggests  the  opening  of  the  bladder  in  the  median 
line,  midway  between  the  scrotum  and  the  anus, 
and  the  placing  of  a  canula  therein,  so  as  to  permit 
drainage  until  healing  occurs. 

Even  this  brief  review  of  the  careers  and  the 


60  OLD-TIME  MAKERS  OF  MEDICINE 

writings  of  the  physicians  of  early  Christian  times 
shows  how  well  the  tradition  of  old  Greek  medicine 
was  being  carried  on.  There  was  much  to  hamper 
the  cultivation  of  science  in  the  disturbances  of  the 
time,  the  gradual  breaking  up  of  the  Eoman  Empire, 
and  the  replacement  of  the  peoples  of  southern 
Europe  by  the  northern  nations,  who  had  come  in, 
yet  in  spite  of  all  this,  medical  tradition  was  well 
preserved.  The  most  prominent  of  the  con- 
servators were  themselves  men  whose  opinions  on 
problems  of  practical  medicine  were  often  of  value, 
and  whose  powers  of  observation  frequently  cannot 
but  be  admired.  There  is  absolutely  no  trace  of 
anything  like  opposition  to  the  development  of  med- 
ical science  or  medical  practice,  but,  on  the  contrary, 
everywhere  among  political  and  ecclesiastical 
authorities,  we  find  encouragement  and  patronage. 
The  very  fact  that,  in  the  storm  and  stress  of  the 
succeeding  centuries,  manuscript  copies  of  the  writ- 
ings of  the  physicians  of  this  time  were  preserved 
for  us  in  spite  of  the  many  vicissitudes  to  which 
they  were  subjected  from  fire,  and  war,  and  acci- 
dents of  various  kinds  for  hundreds  of  years,  until 
the  coming  of  printing,  shows  in  what  estimation 
they  were  held.  During  this  time  they  owed  their 
preservation  to  churchmen,  for  the  libraries  and 
the  copying-rooms  were  all  under  ecclesiastical 
control. 


in 

GEEAT  JEWISH  PHYSICIANS  1 

Any  account  of  Old-Time  Makers  of  Medicine  with- 
out a  chapter  on  the  Jewish  Physicians  would  indeed 
be  incomplete.  They  are  among  the  most  important 
factors  in  medieval  medicine,  representing  one  of 
the  most  significant  elements  of  medical  progress. 
In  spite  of  the  disadvantages  under  which  their  race 
labored  because  of  the  popular  feeling  against  them 
on  the  part  of  the  Christians  in  the  earlier  centuries 
and  of  the  Mohammedans  later,  men  of  genius  from 
the  race  succeeded  in  making  their  influence  felt  not 
only  on  their  own  times,  but  accomplished  so  much 
in  making  and  writing  medicine  as  to  influence  many 
subsequent  generations.  Living  the  segregated  life 
that  as  a  rule  they  had  to,  from  the  earliest  times 

1  My  attention  was  called  to  the  interesting  story  of  the  Jewish 
physicians  of  the  Middle  Ages  and  their  scientific  accomplishment 
while  writing  the  article  on  Joseph  Hyrtl  for  the  Catholic  En- 
cyclopedia. His  "  Das  Arabische  und  Hebraische  in  der  Anatomie  " 
(Wien,  1879)  has  some  interestingly  suggestive  material  on  these  im- 
portant chapters  of  the  history  of  medicine.  (I  owe  my  opportunity 
to  consult  it  to  the  courtesy  of  the  Surgeon-General's  library.) 
Biographic  material  has  been  obtained  from  Carmoly's  "  History  of 
the  Jewish  Physicians,"  translated  by  Dr.  Dunbar  for  the  Maryland 
Medical  and  Surgical  Journal,  some  extra  copies  of  which  were 
printed  by  John  Murphy  and  Co.,  Baltimore,  about  the  middle  of  the 
nineteenth  century.  Baas  and  Haeser's  Histories  of  Medicine  and 
Puschmann  and  Pagel's  "  Handbook  "  provided  additional  material, 
and  I  have  found  Landau's  "  Geschichte  der  Jiidischen  Aerzte  "  (Ber- 
lin,   1895)    of   great  service. 

61 


62  OLD-TIME  MAKERS  OF  MEDICINE 

(the  Ghettos  have  only  disappeared  in  the  nineteenth 
century),  it  would  seem  almost  impossible  for 
them  to  have  done  great  intellectual  work.  It 
is  one  of  the  very  common  illusions,  however, 
that  great  intellectual  work  is  accomplished  mainly 
in  the  midst  of  comfortable  circumstances  and 
as  the  result  of  encouraging  conditions.  Most 
of  our  great  makers  of  medicine  at  all  times, 
and  never  more  so  than  during  the  past  century, 
have  been  the  sons  of  the  poor,  who  have  had 
to  earn  their  own  living,  as  a  rule,  before 
they  reached  manhood,  and  who  have  always  had  the 
spur  of  that  necessity  which  has  been  so  well  called 
the  mother  of  invention.  Their  hard  living  condi- 
tions probably  rather  favored  than  hampered  their 
intellectual  accomplishments. 

It  is  not  unlikely  that  the  difficult  personal  circum- 
stances in  which  the  Jews  were  placed  had  a  good 
deal  to  do  at  all  times  with  stimulating  their  am- 
bitions and  making  them  accomplish  all  that  was  in 
them.  Certain  it  is  that  at  all  times  we  find  a  won- 
derful power  in  the  people  to  rise  above  their  con- 
ditions. With  them,  however,  as  with  other  peoples, 
luxury,  riches,  comfort,  bring  a  surfeit  to  initiative 
and  the  race  does  not  accomplish  so  much.  At  vari- 
ous times  in  the  early  Middle  Ages,  particularly,  we 
find  Jewish  physicians  doing  great  work  and  obtain- 
ing precious  acknowledgment  for  it  in  spite  of  the 
most  discouraging  conditions.  Later  it  is  not  un- 
usual to  find  that  there  has  been  a  degeneration  into 
mere  money-making  as  the  result  of  opportunity 
and  consequent  ease  and  luxury.  At  a  number  of 
times,  however,  both  in  Christian  and  in  Moham- 


GREAT  JEWISH  PHYSICIANS  63 

medan  countries,  great  Jewish  physicians  arose 
whose  names  have  come  to  us  and  with  whom  every 
student  of  medicine  who  wants  to  know  something 
about  the  details  of  the  course  of  medical  history 
must  be  familiar.  There  are  men  among  them 
who  must  be  considered  among  the  great  lights 
of  medicine,  significant  makers  always  of  the 
art  and  also  in  nearly  all  cases  of  the  science  of 
medicine. 

A  little  consideration  of  the  history  of  the  Jewish 
people  and  their  great  documents  eliminates  any  sur- 
prise there  may  be  with  regard  to  their  interest  in 
medicine  and  successful  pursuit  of  it  during  the 
Middle  Ages.  The  two  great  collections  of  Hebrew 
documents,  the  Old  Testament  and  the  Talmud,  con- 
tain an  immense  amount  of  material  with  reference 
to  medical  problems  of  many  kinds.  Both  of  these 
works  are  especially  interesting  because  of  what  they 
have  to  say  of  preventive  medicine  and  with  regard 
to  the  recognition  of  disease.  Our  prophylaxis 
and  diagnosis  are  important  scientific  departments 
of  medicine  dependent  on  observation  rather  than 
on  theory.  While  therapeutics  has  wandered  into 
all  sorts  of  absurdities,  the  advances  made  in  pro- 
phylaxis and  in  diagnosis  have  always  remained 
valuable,  and  though  at  times  they  have  been  for- 
gotten, re-discovery  only  emphasizes  the  value  of 
preceding  work.  It  is  because  of  what  they  contain 
with  regard  to  these  two  important  medical  subjects 
that  the  Old  Testament  and  the  Talmud  are  land- 
marks in  the  history  of  medicine  as  well  as  of  re- 
ligion. 

Baas,  in  his  "  Outlines  of  the  History  of  Medi- 


64  OLD-TIME  MAKERS  OF  MEDICINE 

cine,"  says:  "  It  corresponds  to  the  reality  in  both 
the  actual  and  chronological  point  of  view  to  con- 
sider the  books  of  Moses  as  the  foundation  of  sani- 
tary science.  The  more  we  have  learned  about 
sanitation  in  the  prophylaxis  of  disease  and  in  the 
prevention  of  contagion  in  the  modern  time,  the 
more  have  we  come  to  appreciate  highly  the  teach- 
ings of  these  old  times  on  such  subjects.  Moses 
made  a  masterly  exposition  of  the  knowledge  neces- 
sary to  prevent  contagious  disease  when  he  laid 
down  the  rules  with  regard  to  leprosy,  first  as  to 
careful  differentiation,  then  as  to  isolation,  and 
finally  as  to  disinfection  after  it  had  come  to  be  sure 
that  cure  had  taken  place.  The  great  lawgiver  could 
insist  emphatically  that  the  keeping  of  the  laws  of 
God  not  only  was  good  for  a  man's  soul  but  also  for 
his  body." 

With  this  tradition  familiarly  known  and  deeply 
studied  by  the  mass  of  the  Hebrew  people,  it  is  no 
surprise  to  find  that  when  the  next  great  Hebrew 
development  of  religious  writing  came  in  the  Tal- 
mud during  the  earlier  Middle  Ages,  that  also  con- 
tains much  with  regard  to  medicine,  not  a  little  of 
which  is  so  close  to  absolute  truth  as  never  to  be 
out  of  date.  Friedenwald,  in  his  "  Jewish  Phy- 
sicians and  the  Contributions  of  the  Jews  to  the 
Science  of  Medicine, ' '  a  lecture  delivered  before  the 
Gratz  College  of  Philadelphia  fifteen  years  ago, 
summed  up  from  Baas'  "  History  of  Medicine  "  the 
instructions  in  the  Talmud  with  regard  to  health  and 
disease.  The  summary  represents  so  much  more  of 
genuine  knowledge  of  medicine  and  surgery  than 
might  be  expected  at  the  early  period  at  which  it  was 


GREAT  JEWISH  PHYSICIANS  65 

written,  during  the  first  and  second  century  of  our 
era,  that  it  seems  well  to  quote  it  at  some  length. 

"  Fever  was  regarded  as  nature's  effort  to  expel 
morbific  matter  and  restore  health ;  which  is  a  much 
safer  interpretation  of  fever,  from  a  practical  point 
of  view,  than  most  of  the  theories  bearing  on  this 
point  that  have  been  taught  up  to  a  very  recent 
period.  They  attributed  the  halting  in  the  hind  legs 
of  a  lamb  to  a  callosity  formed  around  the  spinal 
cord.  This  was  a  great  advance  in  the  knowledge 
of  the  physiology  of  the  nervous  system.  An  emetic 
was  recommended  as  the  best  remedy  for  nausea. 
In  many  cases  no  better  remedy  is  known  to-day. 
They  taught  that  a  sudden  change  in  diet  was  injuri- 
ous, even  if  the  quality  brought  by  the  change  was 
better.  That  milk  fresh  from  the  udder  was  the  best. 
The  Talmud  describes  jaundice  and  correctly 
ascribes  it  to  the  retention  of  bile,  and  speaks  of 
dropsy  as  due  to  the  retention  of  urine.  It  teaches 
that  atrophy  or  rupture  of  the  kidneys  is  fatal.  In- 
duration of  the  lungs  (tuberculosis)  was  regarded 
as  incurable.  Suppuration  of  the  spinal  cord  had 
an  early,  grave  meaning.  Babies  was  known.  The 
following  is  a  description  given  of  the  dog's  condi- 
tion :  '  His  mouth  is  open,  the  saliva  issues  from  his 
mouth;  his  ears  drop;  his  tail  hangs  between  his 
legs;  he  runs  sideways,  and  the  dogs  bark  at  him; 
others  say  that  he  barks  himself,  and  that  his  voice 
is  very  weak.  No  man  has  appeared  who  could  say 
that  he  has  seen  a  man  live  who  was  bitten  by  a 
mad  dog.'  The  description  is  good,  and  this  prog- 
nosis as  to  hydrophobia  in  man  has  remained  un- 
altered till  in  our  day  when  Pasteur  published  his 
startling  revelation.  The  anatomical  knowledge  of 
the  Talmudists  was  derived  chiefly  from  dissection 
of  the  animals.  As  a  very  remarkable  piece  of  prac- 
tical anatomy  for  its  very  early  date  is  the  procuring 


66  OLD-TIME  MAKERS  OF  MEDICINE 

of  the  skeleton  from  the  body  of  a  prostitute  by  the 
process  of  boiling,  by  Eabbi  Ishmael,  a  physician, 
at  the  close  of  the  first  century.  He  gives  the  num- 
ber of  bones  as  252  instead  of  232.  The  Talmudists 
knew  the  origin  of  the  spinal  cord  at  the  foramen 
magnum  and  its  form  of  termination ;  they  described 
the  oesophagus  as  being  composed  of  two  coats ;  they 
speak  of  the  pleura  as  the  double  covering  of  the 
lungs ;  and  mention  the  special  coat  of  fat  about  the 
kidneys.  They  had  made  progress  in  obstetrics ;  de- 
scribed monstrosities  and  congenital  deformities; 
practised  version,  evisceration,  and  Caesarian  section 
upon  the  dead  and  upon  the  living  mother.  A.  H. 
Israels  has  clearly  shown  in  his  '  Dissertatio  His- 
torico-Medica  Inauguralis  '  that  Caesarian  section,  ac- 
cording to  the  Talmud,  was  performed  among  the 
Jews  with  safety  to  mother  and  child.  The  surgery 
of  the  Talmud  includes  a  knowledge  of  dislocation  of 
the  thigh  bone,  contusions  of  the  skull,  perforation 
of  the  lungs,  oesophagus,  stomach,  small  intestines, 
and  gall  bladder;  wounds  of  the  spinal  cord,  wind- 
pipe, of  fractures  of  the  ribs,  etc.  They  described 
imperforate  anus  and  how  it  was  to  be  relieved  by 
operation.  Chanina  Ben  Chania  inserted  natural 
and  wooden  teeth  as  early  as  the  second  century, 
C.  E." 

There  is  a  famous  summing  up  of  the  possibilities 
of  life  and  happiness  in  the  Talmud  that  has  been 
often  quoted — its  possible  wanting  in  gallantry  be- 
ing set  down  to  the  times  in  which  it  was  written. 
"Life  is  compatible  with  any  disease,  provided  the 
bowels  remain  open ;  any  kind  of  pain,  provided  the 
heart  remain  unaffected ;  any  kind  of  uneasiness,  pro- 
vided the  head  is  not  attacked;  all  manner  of  evils, 
except  it  be  a  bad  woman. ' ' 

There  are  many  other  interesting  suggestions  in 


GREAT  JEWISH  PHYSICIANS  67 

the  Talmud.  Sometimes  they  have  come  to  be  gen- 
erally accepted  in  the  modern  time,  sometimes  they 
are  only  curious  notions  that  have  not,  however,  lost 
all  their  interest.  The  crucial  incision  for  carbuncle 
is  a  typical  example  of  the  first  class  and  the  sug- 
gestion of  the  removal  of  superfluous  fat  from  within 
the  abdomen  or  in  the  abdominal  wall  itself  by 
operation  is  another.  That  they  had  some  idea  of 
the  danger  of  sepsis  may  be  gathered  from  the  fact 
that  they  suspected  iron  surgical  instruments  and 
advised  the  use  of  others  of  less  enduring  character. 
The  Talmud  itself  was  indeed  a  sort  of  encyclo- 
pedia in  which  was  gathered  knowledge  of  all  kinds 
from  many  sources.  It  was  not  particularly  a  book 
of  medicine,  though  it  contains  so  many  medical 
ideas.  In  many  parts  of  it  the  authors'  regard  for 
science  is  emphatically  expressed.  Landau,  in  his 
"  History  of  Jewish  Physicians,' '  closes  his  account 
of  the  Talmud  with  this  paragraph: 

"  I  conclude  this  brief  review  of  Talmudic  medi- 
cine with  some  reference  to  how  high  the  worth  of 
science  was  valued  in  this  much  misunderstood  work. 
In  one  place  we  have  the  expression  i  occupation  with 
science  means  more  than  sacrifice. '  In  another 
'  science  is  more  than  priesthood  and  kingly  dig- 
nity. 


i  11 1 


2Of  course  there  are  many  absurd  things 'recommended  in  the  Tal- 
mud, We  cannot  remind  ourselves  too  often,  however,  that  there  have 
been  absurd  things  at  all  times  in  medicine,  and  especially  in  therapeu- 
tics. It  is  curious  how  often  some  of  these  absurdities  have  repeated 
themselves.  We  are  liable  to  think  it  very  queer  that  men  should  have 
presumed,  or  somehow  jumped  to  the  conclusion,  that  portions  of  ani- 
mals might  possess  wonderful  virtue  for  the  healing  of  diseases  of  the 
corresponding  special  parts  of  man.     We  ourselves,  however,  within  a 


68  OLD-TIME  MAKERS  OF  MEDICINE 

After  all  this  of  national  tradition  in  medicine  be- 
fore and  after  Christ,  it  is  only  what  we  might  quite 
naturally  expect  to  find,  that  there  is  scarcely  a  cen- 
tury of  the  Middle  Ages  which  does  not  contain  at 
least  one  great  Jewish  physician  and  sometimes 
there  are  more.  Many  of  these  men  made  distinct 
contributions  to  medical  science  and  their  names 
have  been  held  in  high  estimation  ever  since.  Per- 
haps I  should  say  that  they  were  held  in  high  estima- 
tion until  that  neglect  of  historical  studies  which 
characterized  the  eighteenth  century  developed,  and 
that  there  has  been  a  reawakening  of  interest  in  our 
time.  We  forget  this  curious  decadence  of  the  later 
seventeenth  and  eighteenth  centuries  which  did  so 
much  to  obscure  history  and  especially  the  history 
of  the  sciences.  Fortunately  the  scholars  of  the  six- 
teenth and  early  seventeenth  centuries  accomplished 
successfully  the  task  of  printing  many  of  the  books 
of  these  old-time  physicians  and  secured  their  pub- 
lication in  magnificent  editions.  These  were  bought 
eagerly  by  scholars  and  libraries  all  over  Europe 

little  more  than  a  decade,  had  a  phase  of  opotherapy — how  much  less 
absurd  it  seems  under  that  high-sounding  Greek  term— that  was  appar- 
ently very  learned  in  its  scientific  aspects  yet  quite  as  absurd  as  many 
phases  of  old-time  therapy,  as  we  look  at  it.  We  administered  cardin 
for  heart  disease  and  nephrin  for  kidney  trouble,  cerebrin  for  insanity 
(save  the  mark !),  and  even  prostate  tissue  for  prostatism — and  with  re- 
ported good  results !  How  many  of  us  realize  now  that  in  this  we  were 
only  repeating  the  absurdities,  so  often  made  fun  of  in  old  medicine, 
with  regard  to  animal  tissue  and  excrement  therapeutics?  The  Talmud 
has  many  conclusions  with  regard  to  the  symptoms  of  patients  drawn 
from  dreams ;  as,  for  instance,  it  is  said  to  be  a  certain  sign  of  sanguine- 
ous plethora  when  one  dreams  of  the  comb  of  a  cock.  One  phase  of 
our  psycho-analysis  in  the  modern  time,  however,  has  taken  us  back  to 
an  interpretation  of  dreams  different  of  course  from  this,  yet  analogous 
enough  to  be  quite  striking. 


GREAT  JEWISH  PHYSICIANS  69 

in  spite  of  the  high  price  they  commanded  in  that 
era  of  slow,  laborious  printing.  The  Eenaissance 
exhibits  some  of  its  most  admirable  qualities  in  its 
reverence  for  these  old  workers  in  science  and  above 
all  for  the  careful  preparation  by  its  scholars  of  the 
text  of  these  first  editions  of  old-time  physicians. 
The  works  have  often  been  thus  literally  preserved 
for  us,  for  some  of  them  at  least  would  have  disap- 
peared among  the  vicissitudes  of  the  intervening 
time,  most  of  which  was  anything  but  favorable  to 
the  preservation  of  old-time  works,  no  matter  what 
their  content  or  value. 

During  the  second  and  third  centuries  of  our  era, 
while  the  Talmudic  writings  were  taking  shape,  three 
great  Jewish  physicians  came  into  prominence. 
The  first  of  them,  Chanina,  was  a  contemporary  of 
Galen.  According  to  tradition,  as  we  have  said,  he 
inserted  both  natural  and  artificial  teeth  before  the 
close  of  the  second  century.  The  two  others  were 
Bab  or  Eaw  and  Samuel.  Eab  has  the  distinction 
of  having  studied  his  anatomy  from  the  human  body. 
According  to  tradition  he  did  not  hesitate  to  spend 
large  sums  of  money  in  order  to  procure  subjects 
for  dissection.  At  this  time  it  is  very  doubtful 
whether  Galen,  though  only  of  the  preceding  gen- 
eration, ever  had  the  opportunity  to  study  more  than 
animals  or,  at  most,  a  few  human  bodies.  Samuel, 
the  third  of  the  group,  was  an  intimate  friend  of 
Bab's,  perhaps  a  disciple,  and  his  fame  depends 
rather  on  his  practice  of  medicine  than  of  research 
in  medical  science.  He  was  noted  for  his  practical 
development  of  two  specialties  that  cannot  but  seem 
to  us  rather  distant  from  each  other.    His  reputa- 


70  OLD-TIME  MAKERS  OF  MEDICINE 

tion  as  a  skilful  obstetrician  was  only  surpassed  by 
the  estimation  in  which  he  was  held  as  an  oculist. 
He  seems  to  have  turned  to  astronomy  as  a  hobby, 
and  was  highly  honored  for  his  knowledge  of  this 
science.  Probably  there  is  nothing  commoner  in  the 
story  of  great  Jewish  physicians  than  their  success- 
ful pursuit  of  some  scientific  subject  as  a  hobby  and 
reaching  distinction  in  it.  Their  surplus  intellectual 
energy  needed  an  outlet  besides  their  vocation,  and 
they  got  a  rest  by  turning  to  some  other  interest, 
often  accomplishing  excellent  results  in  it.  Like 
most  great  students  with  a  hobby,  the  majority  of 
them  were  long-lived.  Their  lives  are  a  lesson  to  a 
generation  that  fears  intellectual  overwork. 

During  the  fourth  century  we  have  a  number  of 
very  interesting  traditions  with  regard  to  a  great 
Jewish  physician,  Abba  Oumna,  to  whom  patients 
flocked  from  all  over  the  world.  He  seems  particu- 
larly to  have  been  anxious  to  make  his  services  avail- 
able to  the  scholars  of  his  time.  He  looked  upon 
them  as  brothers  in  spirit,  fellow-laborers  whose  in- 
vestigations were  as  important  as  his  own  and  whose 
labors  for  mankind  he  hoped  to  extend  by  the  helpful- 
ness of  his  profession.  In  order  that  it  might  be  easy 
for  them  to  come  to  him  without  feeling  abashed  by 
their  poverty,  and  yet  so  that  they  might  pay  him 
anything  that  they  thought  they  were  able  to,  he 
hung  up  a  box  in  his  anteroom  in  which  each  patient 
might  deposit  whatever  he  felt  able  to  give.  His 
kindliness  towards  men  became  the  foundation  for 
many  legends.  Needless  to  say  he  was  often  im- 
posed upon,  but  that  seems  to  have  made  no  differ- 
ence to  him,  and  he  went  on  straightforwardly  doing 


GREAT  JEWISH  PHYSICIANS  71 

what  lie  thought  he  ought  to  do,  regardless  of  the 
devious  ways  of  men,  even  those  whom  he  was  gen- 
erously assisting.  While  we  do  not  know  much  of 
his  scientific  medicine,  we  do  know  that  he  was  a 
fine  example  of  a  practitioner  of  medicine  on  the 
highest  professional  lines. 

With  the  foundation  of  the  school  at  Djondisabour 
in  Arabistan  or  Khusistan  by  the  Persian  monarch 
Chosroes,  some  Jewish  physicians  come  into  promi- 
nence as  teachers,  and  this  is  one  of  the  first  impor- 
tant occasions  in  history  when  they  teach  side  by 
side  with  Christian  colleagues.  Djondisabour  seems 
distant  from  us  now,  lying  as  it  does  in  the  province 
just  above  the  head  of  the  Persian  Gulf,  and  it  is  a 
little  hard  to  understand  its  becoming  a  centre  of 
culture  and  education,  yet  according  to  well- 
grounded  historical  traditions  students  flocked  here 
from  all  parts  of  the  world,  and  its  medical  instruc- 
tion particularly  became  famous.  According  to  the 
documents  and  traditions  that  we  possess,  clinical 
teaching  was  the  most  significant  feature  of  the 
school  work  and  made  it  famous.  As  a  consequence 
graduates  from  here  were  deemed  fully  qualified  to 
become  professors  in  other  institutions  and  were 
eagerly  sought  by  various  medical  schools  in  the 
East. 

With  the  rise  of  the  strong  political  power  of  the 
Mohammedans  enough  of  peace  came  to  the  East  at 
least  to  permit  the  cultivation  of  arts  and  sciences 
to  some  extent  again,  and  then  at  once  the  eminence 
of  Jewish  physicians,  both  as  teachers  and  practi- 
tioners of  medicine,  once  more  becomes  manifest. 
The  first  of  the  race  who  comes  into  prominence  is 


72  OLD-TIME  MAKERS  OF  MEDICINE 

Maser  Djawah  Ebn  Djeldjal,  of  Basra.  To  him  we 
owe  probably  more  than  to  anyone  else  the  preserva- 
tion of  old  scientific  writings  and  the  cultivation  of 
arts  and  sciences  by  the  Mohammedans.  He  pre- 
vailed on  Caliph  Moawia  I,  whose  physician  he  had 
become,  to  canse  many  foreign  works,  and  especially 
those  written  in  Greek,  to  be  translated  into  Arabic. 
He  seems  to  have  taken  a  large  share  of  the  labor 
of  the  translation  on  himself  and  prevailed  npon 
his  pupil,  the  son  of  Moawia,  to  translate  some  works 
on  chemistry.  The  translation  for  which  Maser 
Djawah  is  best  known  is  that  of  the  Pandects  of 
Haroun,  a  physician  of  Alexandria.  The  transla- 
tion of  this  work  was  made  toward  the  end  of  the 
seventh  century.  Unfortunately  the  "  Pandects  " 
has  not  come  down  to  us,  either  in  original  or  trans- 
lation, but  we  have  fragments  of  the  translation 
preserved  by  Ehazes,  the  distinguished  Arabian 
medical  writer  and  physician  of  the  ninth  century, 
and  there  seems  no  doubt  that  it  contained  the  first 
good  description  of  smallpox,  a  chapter  in  medicine 
that  is  often — though  incorrectly — attributed  to 
Ehazes  himself.  Ehazes  quoted  Maser  Djawah 
freely  and  evidently  trusted  his  declarations  im- 
plicitly. 

The  succeeding  Caliphs  of  the  first  Arabian  dy- 
nasty did  not  exhibit  the  same  interest  in  education, 
and  above  all  in  science,  that  characterized  Moawia. 
Political  ambition  and  the  desire  for  military  glory 
seem  to  have  filled  up  their  thoughts  and  perhaps 
they  had  not  the  good  fortune  to  fall  under  the  in- 
fluence of  physicians  so  wise  and  learned  as  Maser 
Djawah.    More  probably,  however,  they  themselves 


GREAT  JEWISH  PHYSICIANS  73 

lacked  interest.  Toward  the  end  of  the  seventh  cen- 
tury they  were  succeeded  by  the  Abbassides.  Al- 
mansor,  the  second  Caliph  of  this  dynasty,  was  at- 
tacked by  a  dangerous  disease  and  sent  for  a 
physician  of  the  Nestorian  school.  After  his  res- 
toration to  health  he  became  a  liberal  patron  of 
science  and  especially  medical  science.  The  new  city 
of  Bagdad,  which  had  become  the  capital  of  the  realm 
of  the  Abbassides,  was  enriched  by  him  with  a  large 
number  of  works  on  medicine,  which  he  caused  to  be 
translated  from  the  Greek.  He  did  not  confine  him- 
self to  medicine,  however,  but  also  brought  about 
translations  of  works  with  regard  to  other  sciences. 
One  of  these,  astronomy,  was  a  favorite.  He  made 
it  a  particular  point  to  search  out  and  encourage  the 
translation  of  such  books  as  had  not  previously  been 
translated  from  Greek  into  Arabic.  While  he  pro- 
vided a  translation  of  Ptolemy  he  also  had  transla- 
\JJons  made  of  Aristotle  and  Galen. 

It  is  not  surprising,  then,  that  the  school  of  Bag- 
dad became  celebrated.  Jewish  physicians  seem  to 
have  been  most  prominent  in  its  foundation,  and  the 
most  distinguished  product  of  it  is  Isaac  Ben  Emran, 
almost  as  celebrated  as  a  philosopher  as  he  is  as  a 
physician.  One  of  his  expressions  with  regard  to 
the  danger  of  a  patient  having  two  physicians  whose 
opinions  disagree  with  regard  to  his  illness  has  been 
deservedly  preserved  for  us.  Zeid,  an  Emir  of  one 
of  the  chief  cities  of  the  Arabs  in  Barbary,  fell  ill 
of  a  tertian  fever  and  called  Isaac  and  another  phy- 
sician in  consultation.  Their  opinions  were  so  widely 
in  disaccord  that  Isaac  refused  to  prescribe  any- 
thing, and  when  the  Emir,  who  had  great  confidence 


74  OLD-TIME  MAKERS  OF  MEDICINE 

in  him,  demanded  the  reason,  he  replied,  ' '  disagree- 
ment of  two  physicians  is  more  deadly  than  a  tertian 
fever.' '  This  Isaac,  who  is  said  to  have  died  in  799, 
is  the  great  Jewish  physician,  one  of  the  most  im- 
portant members  of  the  profession  in  the  eighth  cen- 
tury. His  principal  work  was  with  regard  to  poisons 
and  the  symptoms  caused  by  them.  This  is  often 
quoted  by  medical  writers  in  the  after  time. 

The  prominent  Jewish  physician  of  the  ninth 
century  was  Joshua  Ben  Nun.  Haroun  al-Baschid, 
whose  attempts  to  secure  justice  for  his  people  are 
the  subject  of  so  much  legendary  lore,  and  whose 
place  in  history  may  be  best  recalled  by  the  fact  that 
he  is  a  contemporary  of  Charlemagne,  was  particu- 
larly interested  in  medicine.  He  founded  the  city  of 
Tauris  as  a  memorial  of  the  cure  of  his  wife.  He 
was  a  generous  patron  of  the  school  of  Djondisabour 
and  established  a  medical  school  also  at  Bagdad.  He 
provided  good  salaries  for  the  professors,  insisted  on 
careful  examinations,  and  raised  the  standard  of 
medical  education  for  a  time  to  a  noteworthy  de- 
gree. The  greatest  teacher  of  this  school  at  Bagdad 
was  Joshua  Ben  Nun,  sometimes  known  as  the  Babbi 
of  Seleucia.  His  teaching  attracted  many  students 
to  Bagdad  and  his  fame  as  one  of  the  great  practi- 
tioners of  medicine  of  this  time  brought  many  pa- 
tients. Among  his  disciples  was  John  Masuee,  whose 
Arabian  name  is  so  different,  Yahia  Ben  Masoviah, 
that  in  order  to  avoid  confusion  in  reading  it  is  im- 
portant to  know  both.  Almost  better  known,  per- 
haps, at  this  time  was  Abu  Joseph  Jacob  Ben  Isaac 
Kendi.  Fortunately  for  the  after  time,  these  men 
devoted  themselves  not  only  to  their  own  observa- 


GREAT  JEWISH  PHYSICIANS  75 

tions  and  writings  but  made  a  series  of  valuable 
translations.  Joshua  Ben  Nun  seems  to  have  been 
particularly  zealous  in  this  matter,  following  the 
example  of  Maser  Djawah  of  Basra. 

Bagdad  then  became  a  centre  for  Arabian  culture. 
Mahmoud,  one  of  Haroun's  successors,  provided  in 
Bagdad  a  refuge  for  the  learned  men  of  the  East 
who  were  disturbed  by  the  wars  and  troubles  of  the 
time.  He  became  a  liberal  patron  of  literature  and 
education.  When  the  Emperor  Michael  III  of  Con- 
stantinople was  conquered  in  battle,  one  of  the  obli- 
gations imposed  upon  him  was  to  send  many  camel 
loads  of  books  to  Bagdad,  and  Aristotle  and  Plato 
were  studied  devotedly  and  translated  into  Arabic. 
The  era  of  culture  affected  not  only  the  capital  but 
all  the  cities,  and  everywhere  throughout  the  Ara- 
bian empire  schools  and  academies  sprang  up.  We 
have  records  of  them  at  Basra,  Samarcand,  Is- 
pahan. From  here  the  thirst  for  education  spread  to 
the  other  cities  ruled  by  the  Mohammedans,  and  each 
town  became  affected  by  it.  Alexandria,  the  cities 
of  the  Barbary  States,  those  of  Sicily  and  Provence, 
where  Moorish  influences  were  prominent,  and  of 
distant  Spain,  Cordova,  Seville,  Toledo,  Granada, 
Saragossa,  all  took  up  the  rivalry  for  culture  which 
made  this  a  glorious  period  in  the  history  of  the 
intellectual  life. 

Already,  in  the  chapter  on  "  Great  Physicians  in 
Early  Christian  Times,' '  I  have  pointed  out  that 
many  of  the  teachers  of  the  Arabs  were  Christian 
physicians.  Here  it  is  proper  to  emphasize  the  other 
important  factor  in  Arabian  medicine,  the  Jewish 
physicians,  who  influenced  the  great  Arabian  rulers, 


76  OLD-TIME  MAKEMS  OF  MEDICINE 

and  were  the  teachers  of  the  Arabs  in  medicine  and 
science  generally.  These  Christian  and  Jewish  phy- 
sicians particularly  encouraged  the  translation  of 
the  works  of  the  great  Greek  physicians  and  thus 
kept  the  Greek  medical  tradition  from  dying  out.  It 
is  not  until  the  end  of  the  ninth,  or  even  the  begin- 
ning of  the  tenth,  century  that  we  begin  to  have 
important  contributors  to  medicine  from  among  the 
Arabs  themselves.  Even  at  this  time  they  have  dis- 
tinguished rivals  among  Jewish  physicians.  Indeed 
these  acquired  such  a  reputation  that  they  became 
the  physicians  to  monarchs  and  even  high  ecclesi- 
astics, and  we  find  them  nearly  everywhere  through- 
out Europe.  Their  success  was  so  great  that  it  is 
not  surprising  that  after  a  time  the  vogue  of  the 
Jewish  physicians  should  have  led  to  jealousy  of 
them  and  to  the  passage  of  laws  and  decrees  limiting 
their  sphere  of  activity. 

The  great  Jewish  physician  of  the  ninth  century 
was  Isaac  Ben  Soliman,  better  known  as  Isaac  el 
Israili,  and  who  is  sometimes  spoken  of  as  d 'Israeli. 
He  was  a  pupil  of  Isaac  Ben  Amram  the  younger, 
probably  a  grandson  of  another  Isaac  Ben  Amram, 
who,  after  having  become  famous  in  Bagdad,  went 
to  Cairo  and  became  the  physician  of  the  Emir  Zi- 
jadeth  III.  The  younger  Isaac  established  a  school, 
and  it  was  with  him  that  Israeli  obtained  his  intro- 
duction to  medicine.  He  practised  first  as  an  oculist 
and  then  became  body-physician  to  the  Sultan  of 
Morocco.  Because  of  the  sympathy  of  his  character 
and  his  unselfishness  he  acquired  great  popularity. 
Hyrtl  refers  to  him  respectfully  as  "  that  scholarly 
son  of  Israel. ' '    Curiously  enough,  considering  racial 


GREAT  JEWISH  PHYSICIANS  11 

feeling  in  the  matter,  he  never  married,  and  when 
asked  why  he  had  not,  and  whether  he  did  not  think 
that  he  might  regret  it,  he  replied,  i '  I  have  written 
four  books  through  which  my  memory  will  be  better 
preserved  than  it  would  be  by  descendants. ' '  The 
four  books  are  his  "  Treatise  on  Fevers,"  his 
"  Treatise  on  Simple  Medicines  and  Ailments,' '  a 
treatise  on  the  "  Elements,"  and  a  treatise  "  On  the 
Urine."  Besides  these,  we  have  from  him  shorter 
works,  "  On  the  Pulse,"  "  On  Melancholy,"  and 
"  On  Dropsy."  His  hope  with  regard  to  his  fame 
from  these  works  was  fulfilled,  for  they  were  printed 
as  late  as  1515  at  Leyden,  and  Sprengel  declared 
them  the  best  compendium  of  simple  remedies  and 
diet  that  we  have  from  the  Arabian  times.  One  of 
his  translators  into  Latin  has  called  him  the  monarch 
of  physicians. 

Some  of  his  maxims  are  extremely  interesting  in 
the  light  of  modern  notions  on  the  same  subjects.  He 
declared  emphatically  that  "  the  most  important 
duty  of  the  physician  is  to  prevent  illness."  "  Most 
patients  get  better  without  much  help  from  the  phy- 
sician by  the  powerofnatoe. "  He  emphasized  his 
distrust  of  using  many  medicines  at  the  same  time 
in  the  hope  that  some  of  them  would  do  good.  He 
laid  it  down  as  a  rule :  ' '  Employ  only  one  medicine 
at  a  time  in  all  your  cases  and  note  its  effects  care- 
fully. ' '  He  was  as  wise  with  regard  to  medical  ethics 
as  therapeutics.  He  advised  a  young  physician, 
"  Never  speak  unfavorably  of  other  physicians. 
Every  one  of  us  has  his  lucky  and  unlucky  hours." 
It  is  pleasant  to  learn  that  the  old  gentleman  lived 
to  fill  out  a  full  hundred  years  of  life,  and  that  in  his 


78  OLD-TIME  MAKERS  OF  MEDICINE 

declining  years  he  was  surrounded  by  the  good  will 
and  the  affection  of  many  who  had  learned  to  know 
his  precious  qualities  of  heart  and  mind.  More  than 
of  any  other  class  of  physicians  do  we  find  the  large 
human  sympathies  of  the  Jewish  physicians  of  the 
Middle  Ages  praised  by  their  contemporaries  and 
succeeding  generations. 

During  the  next  centuries  a  number  of  Jewish  phy- 
sicians became  prominent,  though  none  of  them  until 
Maimonides  impressed  themselves  deeply  upon  the 
medical  life  of  their  own  and  succeeding  centuries. 
Very  frequently  they  were  the  physicians  to  royal 
personages.  Zedkias,  for  instance,  was  the  physician 
to  Louis  the  Pious  and  later  to  his  son  Charles  the 
Bald.  His  reputation  as  a  physician  was  great 
enough  to  give  him  the  popular  estimation  of  a  ma- 
gician, but  it  did  not  save  him  from  the  accusation 
of  having  poisoned  Charles  when  that  monarch  died 
suddenly.  There  seem  to  be  no  good  grounds,  how- 
ever, for  the  accusation.  There  were  a  number  of 
schools  of  medicine,  in  Sicily  and  the  southern  part 
of  Italy,  in  which  Jewish,  Arabian,  and  Christian 
physicians  taught  side  by  side.  One  of  these  teachers 
was  Jude  Sabatai  Ben  Abraham,  usually  known  by 
the  name  of  Donolo,  who  was  famous  both  as  a  writer 
on  medicine  and  on  astronomy.  Donolo  studied  and 
probably  taught  at  Tarentum,  and  there  were  similar 
schools  at  Palermo,  at  Bari,  and  then  later  on  the 
mainland  at  Salerno.  The  foundation  of  Salerno, 
in  which  Jewish  physicians  also  took  part,  we  shall 
discuss  later  in  the  special  chapter  devoted  to  that 
subject. 

One  of  the  great  translators  whose  work  meant 


GREAT  JEWISH  PHYSICIANS  79 

very  much  for  the  medical  science  of  his  own  and 
succeeding  generations  was  the  distinguished  Jewish 
physician,  Faradj  Ben  Salim,  sometimes  spoken  of 
as  Farachi  Faragut  or  Ferrarius,  who  was  born  at 
Girgenti  in  Sicily.  He  made  his  medical  studies  in 
Salerno  and  did  his  work  under  the  patronage  of 
Charles  of  Anjou  towards  the  end  of  the  thirteenth 
century.  His  greatest  work  is  the  translation  of  the 
whole  of  the  "  Continens  "  of  Ehazes.  The  trans- 
lation is  praised  as  probably  the  best  of  its  time 
made  in  the  Middle  Ages.  Faradj  came  at  the  end 
of  a  great  century,  when  the  intellectual  life  of  Eu- 
rope had  reached  a  high  power  of  expression,  and  it 
is  not  surprising  that  he  should  have  proved  equal  to 
his  environment.  This  translation  has  also  some  ad- 
ditions made  by  Faradj  himself,  notably  a  glossary 
of  Arabian  names. 

In  Spain  also  Jewish  physicians  rose  to  distinc- 
tion. The  most  distinguished  in  the  tenth  century 
was  Chasdai  Ben  Schaprut.  Like  many  other  of  the 
great  physicians  of  this  tinxe,  he  had  studied  astron- 
omy as  well  as  the  medical  sciences.  He  became  the 
physician  of  the  Caliph  Abd-er-Eahman  III  of  Cor- 
dova. He  seems  also  to  have  exercised  some  of 
the  functions  of  Prime  Minister  to  the  Caliph,  and 
took  advantage  of  diplomatic  relations  between  his 
sovereign  and  the  Byzantine  Emperor  to  obtain  some 
works  of  Dioscorides.  These  he  translated  into 
Arabian  with  the  help  of  a  Greek  monk,  whom  he 
seems  also  to  have  secured  through  the  diplomatic 
relations.  Undoubtedly  he  did  much  to  usher  in  that 
enthusiasm  for  education  and  study  which  charac- 
terized the  next  centuries,  the  eleventh  and  twelfth, 


80  OLD-TIME  MAKERS  OF.  MEDICINE 

at  Cordova  in  Spain,  when  such  men  as  Avenzoar, 
Avicenna,  and  Averroes  attracted  the  attention  of 
the  educational  world  of  the  time.  Jewish  writers 
have  sometimes  claimed  one  of  the  most  distin- 
guished of  these,  Avenzoar  himself,  as  a  Jew,  but 
Hyrtl  and  other  good  authorities  consider  him  of 
Arabic  extraction  and  point  to  the  fact  that  his  an- 
cestors bore  the  name  of  Mohammed.  This  is  not 
absolutely  conclusive  evidence,  but  because  of  it  I 
have  preferred  to  class  Avenzoar  among  the  Arabian 
physicians. 

The  one  historical  fact  of  importance  for  us  is  that 
everywhere  in  Europe  at  that  time  Jews  were  being 
accorded  opportunities  for  the  study  and  practice  of 
medicine.  There  are  local  incidents  of  persecution, 
but  we  are  not  so  far  away  from  the  feelings  that 
brought  these  about  as  to  misunderstand  them  or  to 
think  that  they  were  anything  more  than  local,  pop- 
ular manifestations.  The  more  we  know  about  the 
details  of  the  medical  history  of  these  times  the 
deeper  is  the  impression  of  academic  freedom  and  of 
opportunities  for  liberal  education. 

Much  has  been  said  about  the  intolerance  of  ec- 
clesiastical authorities  toward  the  Jews,  and  of 
Church  decrees  that  either  absolutely  forbade  their 
practice  of  the  medical  profession  and  their  devo- 
tion to  scientific  study,  or  at  least  made  these  pur- 
suits much  more  difficult  for  them  than  for  others. 
Of  course  it  has  to  be  conceded,  even  by  those  who 
most  insistently  urge  the  existence  of  formal  legis- 
lation in  the  matter,  that  in  spite  of  these  decrees 
and  intolerance  and  opposition,  Jews  continued  to 
practise  medicine  and  to  be  the  chosen  physicians  of 


GREAT  JEWISH  PHYSICIANS  81 

kings  and  even  of  high  ecclesiastical  dignitaries,  as 
well  indeed  of  the  Popes  themselves.  This,  it  is 
usually  declared,  must  be  attributed  to  the  surpass- 
ing skill  of  the  Jewish  physicians,  causing  men  to 
overcome  their  prejudices  and  override  even  their 
own  legal  regulations.  There  is  no  doubt  at  all  about 
the  skill  of  Jewish  physicians  at  many  times  during 
the  Middle  Ages.  There  is  no  doubt  also  of  the  sen- 
timent of  opposition  that  often  developed  between 
the  Christian  peoples  and  the  Jews.  Any  excuse  is 
good  enough  to  justify  men,  to  themselves  at  least, 
in  putting  obstacles  in  the  paths  of  those  who  are 
more  successful  than  they  are  themselves.  Eeligion 
often  became  a  cloak  for  ill-will  and  persecution. 

The  state  of  affairs  that  has  been  presumed  how- 
ever, according  to  which  laws  and  decrees  were  being 
constantly  issued  forbidding  the  practice  of  medicine 
to  Jews  by  the  ecclesiastical  authorities,  while  at 
the  same  time  they  themselves  and  those  who  were 
nearest  to  them  were  employing  Jewish  physicians, 
is  an  absurdity  that  on  the  face  of  it  calls  for  investi- 
gation of  the  conditions  and  from  its  very  appear- 
ance would  indicate  that  the  ordinary  historical 
assumption  in  the  matter  must  be  wrong. 

I  have  been  at  some  pains,  then,  to  try  to  find  out 
just  what  were  the  conditions  in  Europe  with 
regard  to  the  practice  of  medicine  by  the  Jews. 
There  is  no  doubt  that  at  Salerno,  where  the  influ- 
ence of  the  Benedictines  was  very  strong  and  where 
the  influence  of  the  Popes  and  the  ecclesiastical  au- 
thorities was  always  dominant,  full  liberty  of  study- 
ing and  teaching  was  from  the  earliest  days  allowed 
to  the  Jews.   Down  at  Montpellier  it  seems  clear  that 


82  OLD-TIME  MAKERS  OF  MEDICINE 

Jewish  physicians  had  a  large  part  in  the  foundation 
of  the  medical  school,  and  continued  for  several  cen- 
turies to  be  most  important  factors  in  the  mainte- 
nance of  its  reputation  and  the  upbuilding  of  that 
fame  which  draw  students  from  even  distant  parts 
of  Europe  to  this  medical  school  of  the  south  of 
France.  During  the  ninth,  tenth,  eleventh,  and 
twelfth  centuries  Jewish  physicians  were  frequently 
in  attendance  on  kings  and  the  higher  nobility,  on 
bishops  and  archbishops,  cardinals,  and  even  Popes. 
Every  now  and  then  the  spirit  of  intolerance  among 
the  populace  was  aroused,  and  occasionally  the  death 
of  some  distinguished  patient  while  in  a  Jewish  phy- 
sician's hands  was  made  the  occasion  for  persecu- 
tion. W e  must  not  forget,  after  all,  that  even  as  late 
as  Elizabeth's  time,  when  Shakespeare  wrote  "  The 
Merchant  of  Venice,"  he  was  taking  advantage  of 
the  popular  sentiment  aroused  by  the  execution  of 
Lopez,  the  Queen's  physician,  for  a  real  or  supposed 
participation  in  a  plot  against  her  Majesty's  life. 
Shylock  was  presented  the  next  season  for  the  sake 
of  adventitious  popularity  that  would  thus  accrue 
to  the  piece.  The  character  was  played  so  as  to 
depict  all  the  worst  traits  of  the  Jew,  and  was  scorn- 
fully laughed  at  at  every  representation.  This  is 
an  index  of  the  popular  feeling  of  the  time.  Bitter 
intolerance  of  the  Jew  has  continued.  Down  almost 
to  our  own  time  the  Ghettos  have  existed  in  Europe, 
and  popular  tumults  against  them  continue  to  occur. 
Quite  needless  to  say,  these  do  not  depend  on  Chris- 
tianity, but  on  defective  human  nature. 

During  the  Middle  Ages  the  best  possible  criterion 
of  the  attitude  of  the  Church  authorities  towards  the 


GREAT  JEWISH  PHYSICIANS  83 

Jews  is  to  be  found  in  the  legislation  of  Pope  Inno- 
cent III.  He  is  the  greatest  of  the  Popes  of  the 
Middle  Ages;  he  shaped  the  policy  of  the  Church 
more  than  any  other ;  his  influence  was  felt  for  many 
generations  after  his  own  time.  His  famous  edict 
,  with  regard  to  them  was  well  known :  "  Let  no  Chris- 
tian by  violence  compel  them  to  come  dissenting  or 
unwilling  to  Baptism.  Further,  let  no  Christian  ven- 
ture maliciously  to  harm  their  persons  without  a 
judgment  of  the  civil  power  or  to  carry  off  their 
property  or  change  their  good  customs  which  they 
have  hitherto  in  that  district  which  they  inhabit." 
Innocent  himself  and  several  of  his  predecessors  and 
successors  are  known  to  have  had  Jewish  physicians. 
Example  speaks  even  louder  than  precept,  and  the 
example  of  such  men  must  have  been  a  wonderful 
advertisement  for  the  Jewish  physicians  of  the  time. 
Besides  Innocent  III,  many  of  the  Popes  of  the 
twelfth  and  thirteenth  centuries  issued  similar  decrees 
as  to  the  Jews.  It  may  be  recalled  that  this  was  the 
time  when  the  Papacy  was  most  powerful  in  Europe 
and  when  its  decrees  had  most  weight  in  all  coun- 
tries. Alexander  II,  Gregory  IX,  and  Innocent  IV 
all  issued  formal  documents  demanding  the  protec- 
tion of  the  Jews,  and  especially  insisting  that  they 
must  not  be  forced  to  receive  Baptism  nor  disturbed 
in  the  celebration  of  their  festivals.  Clement  VI  did 
the  same  thing  in  the  next  century,  and  even  offered 
them  a  refuge  from  persecution  throughout  the  rest 
of  France  at  Avignon.  Distinguished  Jewish  schol- 
ars, who  know  the  whole  story  from  careful  study, 
have  given  due  credit  to  the  Popes  for  all  that  they 
did  for  their  people.    They  have  even  declared  that 


84  OLD-TIME  MAKEES  OF.  MEDICINE 

if  the  Jews  were  not  exterminated  in  many  of  the 
European  countries  it  was  because  of  the  protection 
afforded  by  the  Church.  We  have  come  to  realize  in 
recent  years  that  persecution  of  the  Jews  is  not  at  all 
a  religious  matter,  but  is  due  to  racial  prejudice  and 
jealousy  of  their  success  by  the  peoples  among  whom 
they  settle.  All  sorts  of  pretexts  are  given  for  this 
persecution  at  all  times.  Formal  Church  documents 
and  the  personal  activities  of  the  responsible  Church 
officials  show  that  during  the  Middle  Ages  the  Church 
was  a  protector  and  not  a  persecutor  of  the  Jews. 

There  is  abundant  historical  authority  for  the 
statement  that  the  Popes  were  uniformly  beneficent 
in  their  treatment  of  the  Jews.  In  order  to  demon- 
strate this  there  is  no  need  to  quote  Catholic  his- 
torians, for  non-Catholics  have  been  rather  emphatic 
in  bringing  it  out.  Neander,  the  German  Protestant 
historian,  for  instance,  said : 

"  It  was  a  ruling  principle  with  the  Popes  after 
the  example  of  their  great  predecessor,  Gregory  the 
Great,  to  protect  the  Jews  in  the  rights  which  had 
been  conceded  to  them.  When  the  banished  Popes 
of  the  twelfth  century  returned  to  Borne,  the  Jews 
went  forth  in  their  holiday  garments  to  meet  them, 
bearing  before  them  the  '  thorn,'  and  Innocent  II, 
on  an  occasion  of  this  sort,  blessed  them." 

English  non-Catholic  historians  can  be  quoted  to 
the  same  effect.  The  Anglican  Dean  Milman,  for  in- 
stance, said:  "  Of  all  European  sovereigns,  the 
Popes,  with  some  exceptions,  have  pursued  the  most 
humane  policy  towards  the  Jews.  In  Italy,  and  even 
in  Rome,  they  have  been  more  rarely  molested  than 
in  the  other  countries.' ' 


GREAT  JEWISH  PHYSICIANS  85 

Hallam  has  expressed  himself  to  the  same  effect, 
especially  as  regards  the  protection  afforded  to  the 
Jew  by  the  laws  of  the  Church  from  the  injustice  of 
those  around  him.  Laws  sometimes  fail  of  their 
purpose  and  the  persecuting  spirit  of  the  populace 
is  often  hard  to  control,  but  everything  that  the  cen- 
tral authority  could  do  to  afford  protection  was  done 
and  essential  justice  was  enshrined  in  the  Church 
laws. 

Prominent  ecclesiastics  would  naturally  follow  the 
lines  laid  down  by  their  Papal  superiors.  The  atti- 
tude of  those  whose  lives  mark  epochs  in  the  history 
of  Christianity  and  who  had  more  to  do  almost  with 
the  shaping  of  the  policy  of  the  Church  at  many 
times  than  the  Popes  themselves,  can  be  quoted 
readily  to  this  same  effect.  Neander  has  called  par- 
ticular attention  to  St.  Bernard's  declarations  with 
regard  to  the  evils  that  would  follow  any  tolerance 
of  such  an  abuse  as  the  persecution  of  the  Jews. 

"  The  most  influential  men  of  the  Church  protested 
against  such  un-Christian  fanaticism.  When  the 
Abbot  Bernard  of  Clairvaux  was  rousing  up  the 
spirit  of  the  nations  to  embark  in  the  second  crusade, 
and  issued  for  this  purpose,  in  the  year  1146,  his  let- 
ters to  the  Germans  (East  Franks),  he  at  the  same 
time  warned  them  against  the  influence  of  those 
enthusiasts  who  strove  to  inflame  the  fanaticism  of 
the  people.  He  declaimed  against  the  false  zeal, 
without  knowledge,  which  impelled  them  to  murder 
the  Jews,  a  people  who  ought  to  be  allowed  to 
live  in  peace  in  the  country. ' ' 

But  it  has  been  said  that  there  are  decrees  against 
Jewish  physicians,  issued  especially  in  the  south  of 


86  OLD-TIME  MAKERS  OF  MEDICINE 

France,  by  various  councils  and  synods  of  the 
Church.  Attention  needs  to  be  called  at  once  to  the 
fact  that  these  are  entirely  local  regulations  and 
have  nothing  to  do  with  the  attitude  of  the  Church 
as  a  whole,  but  represent  what  the  ecclesiastical  au- 
thorities of  a  particular  part  of  the  country  deem 
necessary  for  some  special  reason  in  order  to  meet 
local  conditions.  Indeed  at  the  end  of  the  thirteenth 
and  the  early  fourteenth  century,  when  these  de- 
crees were  being  issued  in  France,  full  liberty  was 
allowed  in  Italy,  and  there  were  no  restrictions 
either  as  to  medical  practice  or  education  founded  on 
adhesion  to  Judaism. 

What  need  to  be  realized  in  order  to  understand 
the  issuance  of  certain  local  ecclesiastical  regula- 
tions forbidding  Jews  to  practise  medicine  are  the 
special  conditions  which  developed  in  France  at  this 
time.  Many  Jews  had  emigrated  from  Spain  to 
France,  and  the  reputation  acquired  by  Jewish  phy- 
sicians at  Montpellier  led  to  a  number  of  the  race 
taking  up  the  practice  of  medicine  without  any  fur- 
ther qualification  than  the  fact  that  they  were  Jews. 
That  gave  them  a  reputation  for  curative  powers  of 
itself  because  of  the  fame  of  some  Jewish  doctors 
and  their  employment  by  the  nobility  and  the  highest 
ecclesiastics.  It  was  hard  to  regulate  these  wander- 
ing physicians.  As  a  consequence  of  this,  the  fac- 
ulty at  Paris,  always  jealous  of  its  own  rights  and 
those  of  its  students,  at  the  beginning  of  the  four- 
teenth century  absolutely  forbade  Jews  from  prac- 
tising on  Christian  patients  within  its  jurisdiction. 
Of  course  the  faculty  of  the  University  of  Paris  was 
dominated  by  ecclesiastical  authorities.    The  medical 


GREAT  JEWISH  PHYSICIANS  87 

school  was,  however,  almost  entirely  independent  of 
ecclesiastical  influence,  and  was  besides  largely  re- 
sponsible for  this  decree.  It  was  felt  that  something 
had  to  be  done  to  stop  the  evil  that  had  arisen  and 
the  charlatanry  and  quackery  which  was  being  prac- 
tised. This  was,  however,  rather  an  attempt  to 
regulate  the  practice  of  medicine  and  keep  it  in  the 
hands  of  medical  school  graduates  than  an  example 
of  intolerance  towards  the  Jews.  Practically  no 
Jews  had  graduated  at  its  university,  Montpellier 
being  their  favorite  school,  and  Paris  was  not  a  little 
jealous  of  its  rights  to  provide  for  physicians  from 
the  northern  part  of  France.  We  have  not  got 
away  from  manifestations  of  that  spirit  even 
yet,  as  our  non-reciprocating  state  medical  laws 
show. 

During  the  next  quarter  of  a  century  decrees  not 
unlike  those  of  the  University  of  Paris  were  issued 
in  the  south  of  France,  especially  in  Provence  and 
Avignon.  Anyone  who  knows  the  conditions  which 
existed  in  the  south  of  France  at  this  time  with  re- 
gard to  medical  practice  will  be  aware  that  a  number 
of  attempts  were  made  by  the  ecclesiastical  authori- 
ties just  at  this  time  to  regulate  the  practice  of  medi- 
cine. Great  abuses  had  crept  in.  Almost  anyone 
who  wished  could  set  up  as  a  physician,  and  those 
who  were  least  fitted  were  often  best  able  to  secure 
a  large  number  of  patients  by  their  cleverness,  their 
knowledge  of  men,  and  their  smooth  tongues.  The 
bishops  of  various  dioceses  met,  and  issued  decrees 
forbidding  anyone  from  practising  medicine  unless 
he  was  a  graduate  of  the  medical  school  of  the  neigh- 
boring University  of  Montpellier.  After  a  time  it  was 


88  OLD-TIME  MAKERS  OF  MEDICINE 

found  that  the  greatest  number  of  violators  of  these 
decrees  were  Jews.  Accordingly  special  regulations 
were  made  against  them.  They  happen  to  be  ec- 
clesiastical regulations,  because  no  other  authority  at 
that  time  claimed  the  right  to  regulate  medical  edu- 
cation and  the  practice  of  medicine. 

What  is  sure  is  that  many  Jewish  physicians 
reached  distinction  under  Christian  as  well  as  Ara- 
bian rulers  at  all  times  during  the  Middle  Ages.  It 
would  be  quite  impossible  in  the  limited  space  at 
command  here  to  give  any  adequate  mention  of  what 
was  accomplished  by  these  Jewish  physicians,  whose 
names  we  have  scarcely  been  able  to  more  than  cata- 
logue, nor  of  the  place  they  hold  in  their  times.  As 
the  physicians  of  rulers,  their  influence  for  culture 
and  the  cultivation  of  science  was  extensive,  and  as 
a  rule  they  stood  for  what  was  best  and  highest  in 
education.  The  story  of  one  of  them,  who  is  gen- 
erally known  in  the  Christian  world  at  least,  Mai- 
monides,  given  in  some  detail,  may  serve  as  a  type 
of  these  Jewish  physicians  of  the  Middle  Ages.  He 
lived  just  before  the  flourishing  period  of  university 
life  in  the  thirteenth  century  brought  about  that 
wonderful  development  of  medicine  and  surgery  in 
the  west  of  Europe  that  meant  so  much  for  the  final 
centuries  of  the  Middle  Ages.  His  works  influenced 
not  a  little  the  great  thinkers  and  teachers  whose 
own  writings  were  to  be  the  foundations  of  education 
for  several  centuries  after  their  time.  Maimonides 
was  well  known  in  the  Western  universities. 
Though  his  life  had  been  mainly  spent  in  the  East, 
and  he  died  there,  there  was  scarcely  a  distinguished 
scholar  of  Europe  who  was  not  acquainted  directly 


GREAT  JEWISH  PHYSICIANS  89 

or  indirectly  with  his  works,  and  the  greater  the 
reputation  of  the  scholar,  as  a  rule,  the  more  he 
knew  of  Maimonides,  Moses  iEgyptaeus,  as  he  was 
called,  and  the  more  frequently  he  referred  to  his 
writings. 


IV 

MAIMONIDES 

The  life  of  one  of  the  great  Jewish  physicians, 
who  has  come  to  be  known  in  history  as  Maimonides, 
is  of  such  significance  in  medical  biography  that 
he  deserves  to  have  a  separate  sketch.  Born  in 
Spain,  his  life  was  lived  in  the  East,  where  his  con- 
nection as  royal  physician  with  the  great  Sultan 
Saladin  of  Crusades  fame  made  his  influence 
widely  felt.  He  is  a  type  of  the  broadly  educated 
man,  conversant  with  the  culture  of  his  time  and  of 
the  past,  knowing  much  besides  medicine,  who  has 
so  often  impressed  himself  deeply  on  medical  prac- 
tice. While  the  narrow  specialists  in  each  genera- 
tion, the  men  who  are  quite  sure  that  they  are  cur- 
ing the  special  ills  of  men  to  which  they  devote 
themselves,  have  always  felt  that  whatever  of 
progress  there  was  in  any  given  time  was  due  to 
them,  they  occupy  but  little  space  as  a  rule  in  the 
history  of  medicine.  The  men  who  loom  large  were 
the  broad-minded,  humanely  sympathetic,  deeply 
educated  physicians,  who  treated  men  and  their  ills 
rather  than  their  ills  without  due  consideration  of 
the  individual,  and  who  not  only  relieved  the  dis- 
comfort of  their  patients  and  greatly  lessened 
human  suffering,  and  added  to  the  sum  of  human 
happiness  in  their  time,  but  also  left  precious  deeply 
significant  lessons   for   succeeding  generations   of 

90 


MAIMONIDES  91 

their  profession.  Hippocrates,  Galen,  Sydenham, 
Auenbrugger,  Morgagni,  these  are  representatives 
of  this  great  class,  and  Maimonides  must  be  con- 
sidered one  of  them. 

Moses  Ben  Maimum,  whose  Arabic  name  was  Abu 
Amran  Musa  Ben  Maimum  Obaid  Alia  el-Cordovi, 
who  was  called  by  his  Jewish  compatriots  Eamban 
or  Rambam,  was  born  at  Cordova  in  Spain,  on  the 
30th  of  March  in  1135  or  1139,  the  year  is  in  doubt. 
It  might  not  seem  of  much  import  now  after  nearly 
eight  centuries,  but  not  a  little  ink  is  spilt  over  it 
yet  by  devoted  biographers. 

We  are  rather  prone  to  think  in  our  time  that  the 
conditions  in  which  men  were  born  and  reared  before 
what  we  are  pleased  to  call  modern  times,  and,  above 
all,  in  the  Middle  Ages,  must  have  made  a  distinct 
handicap  for  their  intellectual  development.  Most 
of  us  are  quite  sure  that  the  conditions  in  medieval 
cities  were  eminently  unsuited  for  the  stimulation  of 
the  intellect,  for  incentive  to  art  impulse,  for  up- 
lift in  the  intellectual  life,  or  for  any  such  broad 
interest  in  what  has  been  so  well  called  the  human- 
ities— the  humanizing  things  that  lift  us  above  ani- 
mal necessities — as  would  make  for  genuinely  lib- 
eral education.  We  are  likely  to  be  set  in  the 
opinion  that  the  environment  of  the  growing  youth 
of  an  old-time  city,  especially  so  early  as  the  middle 
of  the  twelfth  century,  was  poor  and  sordid.  The 
cares  of  the  citizens  are  presumed  to  have  been 
mainly  for  material  concerns,  and,  indeed,  mostly 
for  the  wants  of  the  body.  They  were  only  making 
a  start  on  the  way  from  barbarism  to  something  like 
our  glorious  culmination  of  civilization.    As  "  the 


92  OLD-TIME  MAKERS  OF  MEDICINE 

heirs  to  all  the  ages  in  the  foremost  files  of  time  " 
we  are  necessarily  far  in  advance  of  them,  and  we 
are  only  sorry  that  they  did  not  have  the  oppor- 
tunity to  live  to  see  our  day  and  enjoy  the  benefits 
of  the  evolution  of  humanity  that  is  taking  place 
during  the  eight  centuries  that  have  elapsed. 

As  a  matter  of  fact,  there  was  much  more  of  abid- 
ing profound  interest  in  real  civilization  in  many  a 
medieval  city,  much  more  general  appreciation  of 
art,  much  more  breadth  of  intelligence  and  sym- 
pathy with  what  we  call  the  humanities,  than  in  most 
of  our  large  cities.  The  large  city,  as  we  know  it,  is 
eminently  a  discourager  of  breadth  of  intelligence. 
Specialism  in  the  various  phases  of  money-making 
obscures  culture.  Maimonides,  born  in  Cordova, 
was  brought  up  amid  surroundings  that  teemed  with 
incentives  of  every  kind  to  the  development  of  in- 
telligence, of  artistic  taste,  and  everything  that 
makes  for  cultivation  of  intellect  rather  than  of  in- 
terest in  merely  material  things. 

It  is  well  said  that  it  is  hard  to  judge  the  Cor- 
dova of  old  by  its  tawdry  ruins  of  to-day.  The  edu- 
cated visitor  still  stands  in  awe  and  admiration 
of  the  great  mosque  which  expressed  the  high  cul- 
tivation of  the  Moors  of  this  time.  It  is  a  never- 
ending  source  of  wonder  to  Americans.  The  city 
itself  has  many  reminders  of  that  fine  era  of  Moorish 
culture  and  refinement  of  taste  and  of  art  ex- 
pression, which  made  it  in  the  best  sense  of  the 
word  a  city  beautiful.  The  Arab  invaders  had 
found  a  great  prosperous  country  which  had  been 
the  most  cultured  province  of  the  Eoman  Empire, 
and  on  this  foundation  they  made  a  marvellous  de- 


MAIMONIDES  93 

velopment.  "  The  banks  of  the  Guadalquivir,'' 
says  Mr.  S.  Lane-Poole  in  "  The  Moors  in  Spain  " 
(London,  1887),  "  were  bright  with  marble  houses, 
mosques,  and  gardens,  in  which  the  rarest  flowers 
and  trees  of  other  countries  were  carefully  culti- 
vated, and  the  Arabs  introduced  their  system  of  ir- 
rigation which  the  Spaniards  both  before  and  since 
have  never  equalled.' '  The  greatest  beauty  of  the 
city,  of  course,  had  come,  and  some  of  it  had  gone, 
before  Maimonides '  time.  So  much  remains  in  spite 
of  time  and  war,  and  many  unfortunate  influences, 
that  we  can  have  some  idea  how  beautiful  it  must 
have  been  in  his  youth  seven  centuries  ago,  and 
how  even  more  beautiful  in  the  foretime.  Of  the 
great  mosque  writers  of  travel  can  scarcely  say 
enough.  Mr.  Lane-Poole  says:  "  Travellers  stand 
amazed  among  the  forest  of  columns  which  open  out 
apparently  endless  vistas  on  all  sides.  The  por- 
phyry, jasper,  and  marbles  are  still  in  their  places ; 
the  splendid  glass  mosaics,  which  artists  from  By- 
zantium came  to  make,  still  sparkle  like  jewels  in 
the  walls ;  the  daring  architecture  of  the  sanctuary, 
with  its  fantastic  crossed  arches,  is  still  as  imposing 
as  ever;  the  courtyard  is  still  leafy  with  the  orange 
trees  that  prolong  the  vistas  of  columns.  As  one 
stands  before  the  loveliness  of  the  great  mosque,  the 
thought  goes  back  to  the  days  of  the  glories  of  Cor- 
dova, the  palmy  days  of  the  Great  Khalif,  which 
will  never  return." 

Of  all  the  countries  in  which  the  Jews  all  down 
the  centuries  have  lived  there  is  probably  none  of 
which  they  have  been  more  loud  in  praise  than 
Spain.     Their  poets  sang  of  it  as  if  it  were  their 


94  OLD-TIME  MAKERS  OF  MEDICINE 

own  country;  for  centuries  the  people  were  happier 
here  than  probably  they  have  been  anywhere  else 
for  so  long  a  period.  Elsewhere  in  this  book  I  have 
called  attention  to  all  that  Spain  meant  in  Europe 
during  all  the  centuries  from  the  beginning  of  the 
Roman  Empire  down  to  the  end  of  the  Middle  Ages. 
Maimonides  was  fortunate  in  his  birthplace,  then, 
and  while  circumstances  compelled  the  family  to 
move  away,  this  change  did  not  come  until  a  good 
effect  had  been  produced  on  the  mind  of  the  grow- 
ing youth.  Even  when  persecution  came,  Maimon- 
ides clung  to  Spain  with  a  tenacity  born  of  deep 
affection  and  emphasized  by  admiration  for  all 
that  she  was  and  had  been.  Cordova  was  the  jewel 
of  the  Spain  of  this  time,  and  though  much  less 
than  she  had  been  in  the  long  preceding  time,  when 
she  was  the  birthplace  of  Lucan  and  the  two  Senecas, 
or  even  than  what  she  had  been  in  Abd-er-Rahman's 
days,  or  when  she  was  the  birthplace  of  Averroes, 
still  she  remained  wonderfully  beautiful  and  at- 
tractive, winning  and  holding  the  affections  of  men. 
Maimonides'  father,  Maimum  Ben  Joseph,  was  a 
member  of  the  Rabbinical  College  of  Cordova,  and 
famous  for  his  knowledge  of  the  Talmud.  There 
are  some  writings  of  his  on  mathematics  and 
astronomy  extant.  He  directed  the  education  of  his 
son,  who,  like  many  another  distinguished  scholar 
in  later  life,  seems  to  have  exhibited  very  little 
talent  in  his  early  years.  There  is  no  rule  in  the 
matter.  Precocity  often  disappoints.  Genius  is 
often  dull  in  childhood,  but  there  are  exceptions  that 
prove  both  rules.  The  basis  of  education  in  Spain 
at  that  time  among  the  Jews  was  the  Bible,  the 


MAIMONIDES  95 

Talmud,  mathematics,  and  astronomy,  a  good 
rounded  education  in  literature,  the  basis  of  law, 
and  some  exact  physical  science.  After  his  prelim- 
inary education  at  home  Maimonides  studied  the 
natural  sciences  and  medicine  with  Moorish  teach- 
ers. Nature-study,  in  spite  of  frequent  expressions 
that  declare  it  new  in  modern  times,  is  as  old  as 
man.  He  also  received  a  grounding  in  philosophy 
as  a  preparation  for  his  scientific  studies.  At  the 
age  of  twenty-three  he  began  the  composition  of  a 
commentary  on  the  Talmud,  which  he  continued  to 
work  at  on  his  journeys  in  Spain  and  in  Egypt. 
This  is  considered  to  be  one  of  the  most  important 
of  this  class  of  works  extant,  though,  almost  need- 
less to  say,  similar  writings  are  very  numerous. 

In  the  light  of  wanderings  in  philosophy  during 
the  centuries  since,  it  is  rather  interesting  to  quote 
from  that  work  the  end  of  man  as  this  Jewish 
philosopher  of  the  middle  of  the  twelfth  century 
saw  it.  Eecent  teleological  tendencies  in  biology 
add  to  the  interest  of  his  views.  According  to 
Maimonides,  ' '  Man  is  the  end  of  the  whole  creation, 
and  we  have  only  to  look  to  him  for  the  reason  for 
its  existence.  Every  object  shows  the  end  for 
which  it  was  created.  The  palm-trees  are  there  to 
provide  dates ;  the  spider  to  spin  her  webs.  All  the 
properties  of  an  animal  or  a  plant  are  directed  so 
as  to  enable  it  to  reach  its  purpose  in  life.  What  is 
the  purpose  of  man?  It  cannot  lie  alone  in  eating 
and  drinking  or  yielding  to  passion,  nor  in  the 
building  of  cities  and  the  ruling  of  others,  since 
these  objects  lie  outside  of  him,  and  do  not  touch  his 
essential  being.    Such  material  striving  he  has  in 


96  OLD-TIME  MAKERS  OF  MEDICINE 

common  with  the  animal.  A  man  is  lifted  from  a 
lower  to  a  higher  condition  by  his  reason.  Only 
through  his  reason  is  he  placed  above  the  animals. 
He  is  the  only  reasonable  animal.  His  reason  en- 
ables him  to  understand  all  things,  especially  the 
Unity  of  Glod,  and  all  knowledge  and  science  serve 
only  to  direct  man  to  the  knowledge  of  God.  Pas- 
sions are  to  be  subdued,  since  the  man  who  yields 
to  passion  subjects  his  spirit  to  his  body,  and  does 
not  reveal  in  himself  the  divine  power  which  in  him 
lies  in  his  reason,  but  is  swallowed  up  in  the  ocean 
of  matter.' ' 

Not  long  after  Maimonides  passed  his  twentieth 
year  the  family,  consisting  of  the  father  and  his 
two  sons,  Moses  and  David,  and  a  daughter,  moved 
from  Cordova  to  Fez,  compelled  by  Jewish  persecu- 
tions. Here  it  is  said  that  they  had  to  submit  to 
wearing  the  mask  of  Islam  in  order  to  lead  a  peace- 
ful existence.  This  has  been  doubted,  however,  and 
his  whole  life  is  in  flagrant  contradiction  with  any 
such  even  apparent  apostasy  from  the  faith  of  his 
fathers.  Father  and  son  took  advantage  of  the 
opportunity  of  intercourse  with  Moorish  physicians 
and  philosophers  to  increase  their  store  of  knowl- 
edge, but  could  not  be  content  in  the  political  and 
religious  conditions  in  which  they  were  compelled 
to  live.  About  1155,  then,  they  went  to  Jerusalem, 
but  found  conditions  even  more  intolerable  there, 
and  turned  back  to  Egypt,  where  they  settled  down 
in  Old  Cairo.  In  1166  the  father  died,  and  after 
this  we  learn  that  the  sons  made  a  livelihood,  and 
even  laid  the  foundation  of  a  fortune,  by  carrying 
on  a  jewelry  trade.    Moses  still  devoted  most  of  his 


MAIMONIDES  97 

time  to  study,  while  his  brother  did  most  of  the 
business,  but  the  brother  was  lost  in  the  Indian 
Ocean,  and  with  him  went  not  only  a  large  sum  of 
his  own  money,  but  also  much  that  had  been  en- 
trusted to  him  by  others.  Maimonides  undertook 
to  pay  off  these  debts  and  at  the  same  time  had  to 
meet  the  necessities  not  only  of  himself  and  sister, 
but  also  of  the  family  of  his  dead  brother.  It  was 
then  that  he  took  up  the  practice  of  medicine  and 
succeeded  in  making  a  great  name  and  reputation 
for  himself.  He  continued  to  write,  however,  and 
completed  his  commentary  on  the  Talmud. 

About  the  age  of  fifty  Maimonides,  as  seems  to  be 
true  of  a  good  many  men  who  live  to  old  age,  be- 
came rather  discouraged  and  despondent  about  him- 
self. He  refers  to  himself  in  his  letters  and 
writings  rather  frequently  as  an  old  and  ailing  man. 
He  had  nearly  twenty  years  of  active  life  ahead  of 
him,  but  he  had  the  persuasion  that  comes  to  many 
that  he  was  probably  destined  to  an  early  death. 
His  son  was  born  shortly  after  this  time,  and  that 
seems  to  have  had  not  a  little  to  do  with  brightening 
his  life.  While  in  Egypt  Maimonides  married  the 
sister  of  one  of  the  royal  secretaries,  who,  in  turn, 
wedded  Maimonides '  sister.  Maimonides  took  on 
himself  the  education  of  his  son,  who  also  became 
a  physician,  though  his  father  was  not  to  have  the 
satisfaction  of  watching  his  success  in  the  practice 
of  his  chosen  profession.  This  son,  Abraham,  be- 
came the  physician  of  Malie  Alkamen,  the  brother 
of  Saladin,  and,  besides,  was  a  physician  to  the  hos- 
pital at  Cairo.  His  son,  David,  the  grandson  of 
Maimonides,  practised  medicine  also  at  Cairo  till 


98  OLD-TIME  MAKERS  OF  MEDICINE 

1300.  He  in  turn  left  two  sons,  Abraham  and  Solo- 
mon, who  achieved  reputation  in  the  chosen  pro- 
fession of  their  great-grandfather. 

Maimonides,  after  the  birth  of  his  son,  became 
one  of  the  busiest  of  practising  physicians.  Indeed, 
it  is  hard  to  understand  how  he  had  the  time  to  do 
any  writing  in  his  busy  life.  Still  less  can  we  un- 
derstand his  time  for  teaching.  He  was  the  physi- 
cian to  Saladin,  whose  relations  with  Eichard  Cceur 
de  Lion  have  made  him  known  to  English-speaking 
people.  Every  morning,  as  the  Court  physician, 
Maimonides  went  to  the  palace,  situated  half  a  mile 
away  from  his  dwelling,  and  if  any  of  the  many  of- 
ficials and  dependents  that  then,  as  now,  were  at 
Oriental  courts,  were  ill,  he  stayed  there  for  some 
time.  As  a  rule  he  could  only  get  back  to  his  own 
home  in  the  afternoon,  and  then  he  was,  as  he  says 
himself,  "  almost  dying  with  hunger.' '  Knowing 
the  scantiness  of  the  Oriental  breakfast,  we  are  not 
surprised.  There  he  found  his  waiting-room  full 
of  patients,  "  Jews  and  Mohammedans,  prominent 
and  unimportant,  friends  and  enemies,' '  he  says 
himself,  "  a  varied  crowd,  who  are  looking  for  my 
medical  advice.  There  is  scarcely  time  for  me  to 
get  down  from  my  carriage  and  wash  myself  and 
eat  a  little,  and  then  until  night  I  am  constantly 
occupied,  so  that,  from  sheer  exhaustion,  I  must  lie 
down.  Only  on  the  Sabbath  day  have  I  the  time  to 
occupy  myself  with  my  own  people  and  my  studies, 
and  so  the  day  is  away  from  me."  What  a  picture 
it  is  of  the  busy  medical  teacher  at  all  times  in  the 
world's  history,  yet  it  must  not  be  forgotten  that 
it  is  from  these  busy  men  that  we  have  derived  our 


MAIMONIDES  99 

most  precious  lessons  in  caring  for  patients  rather 
than  disease,  in  the  art  of  medicine  rather  than  med- 
ical science — and  their  practical  lessons  have  been 
valuable  long  after  the  fine-spun  theories  of  the 
scientist  that  took  so  long  to  elaborate  have  been 
placed  definitely  in  the  lumber  room. 

His  reputation  as  a  writer  on  medical  topics  is 
not  as  great  as  that  which  has  been  accorded  him 
for  his  writings  on  philosophy  and  in  Talmudic 
literature,  but  he  well  deserves  a  place  among  the 
great  practical  masters  of  medicine,  as  well  as  high 
rank  among  the  physicians  of  his  time.  There  is 
little  that  is  original  in  his  writing,  but  his  thorough- 
going common  sense,  his  wide  knowledge,  and  his 
discriminating,  eclectic  faculty  make  his  writings 
of  special  value.  As  might  have  been  expected,  the 
Aphorisms  of  Hippocrates  attracted  his  attention, 
and,  besides,  he  wrote  a  series  of  aphorisms  of  his 
own.  The  most  interesting  of  his  writings,  how- 
ever, is  a  series  of  letters  on  dietetics  written  for 
the  son  of  his  patron  Saladin.  The  young  prince 
seems  to  have  suffered  from  one  of  the  neurotic  con- 
ditions that  so  often  develop  in  those  who  have  their 
lives  all  planned  for  them,  and  little  incentive  to  do 
things  for  themselves.  The  main  portion  of  his 
complaints  centred,  as  in  the  case  of  many  another 
individual  of  leisure,  in  disturbances  of  digestion. 
Besides,  he  suffered  from  constipation  and  feelings 
of  depression.  Doubtless,  like  many  a  young  per- 
son of  the  modern  time,  he  was  quite  sure  that  these 
symptoms  portended  some  insidious  organic  ail- 
ment that  would  surely  bring  an  early  death.  When 
fathers,  having  done  all  that  there  is  to  do,  just  ex- 


100  OLD-TIME  MAKERS  OF  MEDICINE 

pect  their  sons  to  enjoy  the  fruits  of  the  paternal 
accomplishments,  conditions  of  this  kind  very  often 
develop,  unless  the  young  man  proceeds  to  occupy 
himself  with  even  more  dangerous  distractions  than 
he  finds  in  unending  thought  about  his  own  feelings. 
The  rules  of  life  and  health  that  Maimonides  laid 
down  in  these  letters  have  become  part  of  our  pop- 
ular medical  tradition.  Probably  more  of  the 
ordinarily  current  maxims  as  to  health  have  been 
derived  from  them  than  would  possibly  be  suspected 
by  anyone  not  familiar  with  them.  In  various 
forms  his  rules  have  been  published  a  number  of 
times.  A  good  idea  of  them  can  be  obtained  from 
the  following  compendium  of  them,  which  I  ab- 
breviate from  a  biographical  sketch  of  Maimonides 
by  Dr.  Oppler,  which  appeared  in  the  "  Deutsches 
Archiv  fur  Geschichte  der  Medizin  und  Medicinische 
Geographie  "  (Bd.  2,  Leipzig,  1879). 

1.  Man  is  bound  to  lead  a  life  pleasing  to  God  if 
he  wants  to  have  a  healthy  body,  and  he  must  hold 
himself  far  from  everything  that  can  hurt  his  health 
and  accustom  himself  to  whatever  renews  his 
strength.  He  should  eat  and  drink  only  when  hungry 
and  thirsty  and  should  be  particularly  careful  of  the 
regular  evacuation  of  his  bowels  and  of  his  bladder. 
He  must  not  delay  either  of  these  operations,  but  as 
far  as  possible  satisfy  the  inclination  at  once. 

2.  A  man  must  not  overload  his  stomach  but 
be  content  always  with  something  less  than  is  neces- 
sary to  make  him  feel  quite  satisfied.  He  should  not 
drink  much  during  the  meal  and  only  of  water  and 
wine  mixed,  taking  somewhat  more  after  digestion 
has  begun  and  after  digestion  is  completed,  in  mod- 
eration according  to  his  needs.  Before  a  man  sits 
down  to  table  he  should  note  whether  he  has  any 


MAIMONIDES  101 

tendency  to  evacuation  and  should  make  the  body 
warm  by  movement  and  activity.  After  this  exercise 
he  should  rest  a  little  before  taking  food.  It  is  very 
beneficial  after  work  to  take  a  bath  and  then  the 
meal. 

3.  Food  should  be  taken  always  in  the  sitting 
position.  There  should  be  no  riding  nor  walking,  nor 
movements  of  the  body  until  digestion  is  finished. 
The  man  who  takes  a  walk  or  any  strenuous  occu- 
pation immediately  after  eating  subjects  himself  to 
serious  dangers  of  disease. 

4.  Day  and  night  should  be  divided  into  twenty- 
four  hours.  Men  should  sleep  for  eight  hours,  and 
so  arrange  their  sleep  that  the  end  of  it  comes  with 
the  dawn,  so  that  from  the  beginning  of  sleep  until 
sunrise  there  should  be  an  eight-hour  interval.  We 
should  all  leave  our  beds  about  the  time  that  the  sun 
rises. 

5.  During  sleep  a  man  should  lie  neither  on  his 
face  nor  on  his  back  but  on  his  side,  the  beginning 
of  the  night  on  his  left  and  at  the  end  on  his  right. 
He  should  not  go  to  sleep  for  three  or  four  hours 
after  eating  and  should  not  sleep  during  the  day. 

6.  Fruits  that  are  laxative,  as  grapes,  figs, 
melons,  gourds,  should  be  taken  only  before  meal 
time  and  not  mixed  with  other  food.  It  would  be 
better  to  let  these  get  into  the  abdominal  organs 
and  then  take  other  food. 

7.  Eat  what  is  easily  digestible  before  what  is 
difficult  of  digestion.  The  flesh  of  birds  before  beef 
and  the  flesh  of  calves  before  that  of  cows  and  steers. 
(Birds  were  then  thought  more  digestible  than  other 
flesh;  we  have  reversed  the  ruling.  The  note  shows 
how  light  and  digestible  their  flesh  was  considered 
and  the  reason  therefor.) 

8.  In  summer  eat  cooling  food,  acids,  and  no 
spices.  In  winter,  on  the  contrary,  eat  warming 
foods,  rich  in  spices,  mustard,  and  other  heating  sub- 


102  OLD-TIME  MAKERS  OF  MEDICINE 

stances.    In  cold  and  warm  climates  one  should  eat 
according  to  the  climatic  conditions. 

9.  There  are  certain  harmful  foods  that  should 
be  avoided.  Large  salt  fish,  old  cheese,  old  pickled 
meat,  young  new  wine,  evil-smelling  and  bitter  foods 
are  often  poisonous.  There  are  also  some  which  are 
less  harmful,  but  are  not  to  be  recommended  as  ordi- 
nary nutritive  materials.  Large  fish,  cheese,  milk 
more  than  twenty-four  hours  after  milking,  the  flesh 
of  old  oxen,  beans,  peas,  unleavened  bread,  sauer- 
kraut, onions,  radishes  and  the  like.  These  are  to  be 
taken  only  in  small  quantities  and  only  in  the  winter 
time  and  they  should  be  avoided  in  the  summer. 
Beans  and  lentils  are  to  be  recommended  neither  in 
winter  nor  summer. 

10.  As  a  rule  one  should  avoid  the  eating  of  tree 
fruits,  or  not  eat  much  of  them,  especially  when 
they  are  dry  and  even  less  when  they  are  green.  If 
they  are  unripe  they  may  cause  serious  damage.  Jo- 
hannesbrod  is  very  harmful  at  all  times,  as  are  also 
all  the  sour  fruits,  and  only  small  amounts  of  them 
should  be  eaten  in  summer  or  in  warm  countries. 

11.  The  fruits  that  are  to  be  recommended  dry 
as  well  as  fresh,  are  figs,  grapes,  and  almonds. 
These  may  be  eaten  as  one  has  the  appetite  for  them, 
but  one  should  not  accustom  himself  to  eat  them 
much,  though  they  are  healthier  than  all  other  fruits. 

12.  Honey  and  wine  are  not  good  for  children, 
though  they  are  beneficial  for  older  people,  especially 
in  winter.  In  summer  one-third  less  of  them  should 
be  eaten  than  in  winter. 

13.  Special  care  should  be  taken  to  have  regular 
movements  of  the  bowels  that  carry  off  the  impuri- 
ties of  the  body.  It  is  an  axiom  in  medicine,  that 
so  long  as  evacuations  are  absent,  or  difficult,  or  re- 
quire strong  efforts,  the  individual  is  liable  to  seri- 
ous disease.  Every  medical  means  should  be  taken 
to  overcome  constipation  in  order  to  escape  its  dan- 


MAIMONIDES  103 

gers.  For  this  purpose  young  people  should  be 
given  salty  food,  materials  that  have  been  soaked  in 
olive  oil,  salt  itself,  or  certain  vegetable  soups  with 
olive  oil  and  salt.  Older  people  should  take  honey 
mixed  with  warm  water  early  in  the  morning  and 
four  hours  later  should  take  their  breakfast.  This 
proceeding  should  be  followed  up  from  one  to  four 
days  until  the  constipation  is  overcome. 

14.  Another  axiom  of  medicine  is  that  so  long  as 
a  man  is  able  to  be  active  and  vigorous,  does  not 
eat  until  he  is  over-full,  and  does  not  suffer  from 
constipation,  he  is  not  liable  to  disease.  Even  such 
men,  however,  are  much  safer  if  they  do  not  take 
food  that  may  disagree  with  them. 

15.  Whoever  gives  himself  up  to  inactivity,  or 
puts  off  evacuations  of  the  bowels,  or  suffers  from 
constipation,  will  be  sure  to  suffer  from  many  dis- 
eases and  will  see  his  strength  disappear  even  should 
he  eat  the  best  food  in  the  world  and  make  use  of  all 
the  remedies  that  physicians  have.  Immoderate  eat- 
ing is  a  poison  for  men  and  the  cause  of  many  dis- 
eases which  attack  them.  Most  diseases  come  from 
either  eating  too  much  or  partaking  of  unsuitable 
food.  That  was  what  Solomon  meant  with  his 
proverb : ' '  He  who  puts  a  guard  over  his  mouth  and 
his  tongue  protects  himself  from  many  evils,"  that 
is  to  say,  whoever  protects  his  mouth  from  the  over- 
indulgence in  food  and  his  tongue  from  unsuitable 
speech  protects  himself  from  many  evils. 

16.  Every  week  at  least  a  man  should  take  a 
warm  bath.  One  should  not  bathe  when  hungry,  nor 
after  eating  until  the  food  is  digested,  and  bathe  the 
whole  body  in  warm  but  not  too  hot  water  and  the 
head  in  hot  water.  Afterwards  the  body  should  be 
washed  in  lukewarm  and  cool  water  until  finally  cold 
water  is  used.  One  should  pour  neither  cold  nor 
even  lukewarm  water  on  the  head,  nor  bathe  in  cold 
water  in  the  winter  time,  nor  when  the  body  is 


104  OLD-TIME  MAKERS  OF  MEDICINE 

tired  and  in  perspiration.    At  such  times  the  bath 
should  be  put  off  for  a  while. 

17.  As  soon  as  one  leaves  the  bath  one  should 
cover  oneself,  and  especially  cover  the  head,  so  that 
no  draught  may  strike  it.  Even  in  summer,  care 
must  be  taken  to  observe  this  rule.  After  this  one 
should  rest  for  a  while  until  the  heat  of  the  body 
passes  off  and  then  should  go  to  table.  If  one  could 
sleep  a  little  just  before  a  meal  it  is  often  very  bene- 
ficial. Neither  during  the  bath  nor  immediately  after 
it  should  cold  water  be  drunk,  and  if  there  is  an 
inappeasable  thirst  a  little  wine  and  water  or  water 
and  honey  should  be  taken.  In  winter  it  is  beneficial 
to  rub  the  body  with  oil  after  the  bath. 

18.  Venesection  should  not  be  practised  fre- 
quently, for  it  is  only  meant  for  serious  illness.  It 
should  not  be  permitted  in  winter  or  summer,  nor 
during  the  months  of  April  or  September  ( thej '  r " 
months).  After  passing  his  fiftieth  year  an  indi- 
vidual should  abstain  from  venesection.  Venesec- 
tion should  not  be  practised  on  the  day  when  one 
takes  a  bath  or  goes  on  a  journey  or  returns  from  it. 
On  the  day  when  it  is  practised  less  than  usual 
should  be  eaten  and  drunk,  and  the  patient  should 
give  himself  to  rest,  undertake  no  work  nor  bother- 
some occupation,  and  take  no  walk. 

19.  Whoever  observes  these  rules  of  life  faith- 
fully I  guarantee  him  a  long  life  without  disease. 
He  shall  reach  a  good  old  age,  and  when  he  comes 
to  die  will  not  need  a  physician.  His  body  will  re- 
main always  strong  and  healthy,  unless  of  course 
he  has  been  born  with  a  weak  nature,  or  has  had  an 
unfortunate  bringing  up,  or  should  be  attacked  by 
epidemic  disease  or  by  famine. 

20.  Only  the  healthy  should  keep  these  rules. 
Whoever  is  ill  or  a  sufferer  from  any  injuries,  or 
has  lost  his  health  through  bad  habits,  for  him  there 
are  special  rules  for  each  disease,  only  to  be  found 


MAIMONIDES  105 

in  the  medical  books.  Let  it  be  remembered  that 
every  change  in  a  life  habit  is  the  beginning  of  an 
ailment. 

21.  If  no  physician  can  be  secured,  then  ailing 
people  may  use  these  rules  as  well  as  the  healthy. 

These  rules  are,  of  course,  full  of  the  common 
sense  of  medicine  that  endures  at  all  times.  For 
the  tropical  climate  of  the  Eastern  countries  they 
probably  represent  as  good  advice  as  could  be  given 
even  at  the  present  time.  With  them  before  us  it  is 
not  surprising  to  find  that  on  other  subjects  Mai- 
monides  was  just  as  sensible.  Perhaps  in  nothing  is 
this  more  striking  than  in  his  complete  rejection  of 
astrology.  Considering  how  long  astrology,  in  the 
sense  of  the  doctrine  of  the  stars  influencing  human 
health  and  destinies,  had  dominated  men's  minds, 
and  how  universal  was  the  acceptance  of  it,  Mai- 
monides'  strong  expressions  show  how  much  genius 
lifts  itself  above  the  popular  persuasions  of  its 
time,  even  among  the  educated,  and  how  much  it 
anticipates  subsequent  knowledge. 

It  is  well  to  remind  ourselves  that  as  late  as  the 
middle  of  the  eighteenth  century  Mesmer's  thesis 
on  ' l  The  Influence  of  the  Stars  on  Human  Constitu- 
tions "  was  accepted  by  the  faculty  of  the  University 
of  Vienna  as  a  satisfactory  evidence  not  only  of  his 
knowledge  of  medicine,  but  of  his  power  to  reason 
about  it.  At  the  end  of  the  twelfth  century  Maimon- 
ides  was  trying  to  argue  it  out  of  existence  on  the 
best  possible  grounds.  "  Know,  my  masters,"  he 
writes,  "  that  no  man  should  believe  anything  that 
is  not  attested  by  one  of  these  three  sanctions : — ra- 
tional proof  as  in  mathematical  science,  the  percep- 


106  OLD-TIME  MAKERS  OF  MEDICINE 

tion  of  the  senses,  or  traditions  from  the  prophets 
and  learned  men."  His  biographer  in  the  mono- 
graph "  Maimonides,"  published  by  the  Jewish 
Publication  Society  of  America,1  expresses  his 
further  views  on  the  subject  in  compendious  form, 
and  then  gives  his  final  conclusion  as  follows : 

"  '  Works  on  astrology  are  the  product  of  fools, 
who  mistook  vanity  for  wisdom.  Men  are  inclined 
to  believe  whatever  is  written  in  a  book,  especially 
if  the  book  be  ancient;  and  in  olden  times  disaster 
befell  Israel  because  men  devoted  themselves  to  such 
idolatry  instead  of  practising  the  arts  of  martial  de- 
fence and  government. '  He  says,  that  he  had  him- 
self studied  every  extant  astrological  treatise,  and 
had  convinced  himself  that  none  deserved  to  be  called 
scientific.  Maimonides  then  proceeds  to  distinguish 
between  astrology  and  astronomy,  in  the  latter  of 
which  lies  true  and  necessary  wisdom.  He  ridicules 
the  supposition  that  the  fate  of  man  could  be  de- 
pendent on  the  constellations,  and  urges  that  such 
a  theory  robs  life  of  purpose,  and  makes  man  a 
slave  of  destiny.  '  It  is  true,'  he  concludes,  '  that 
you  may  find  strange  utterances  in  the  Rabbinical 
literature  which  imply  a  belief  in  the  potency  of  the 
stars  at  a  man's  nativity,  but  no  one  is  justified  in 
surrendering  his  own  rational  opinions  because  this 
or  that  sage  erred,  or  because  an  allegorical  remark 
is  expressed  literally.  A  man  must  never  cast  his 
own  judgment  behind  him ;  the  eyes  are  set  in  front, 
not  in  the  back.'  " 

While  Maimonides  could  be  so  positive  in  his 
opinions  with  regard  to  a  subject  on  which  he  felt 
competent  to  say  something,  he  was  extremely  mod- 

1 "  Maimonides,"  by  David  Yellin  and  Israel  Abrahams,  Philadelphia, 
1903. 


MAIMONIDES  107 

est  with  regard  to  many  of  the  great  problems  of 
medicine.  He  often  uses  the  expression  in  his 
writings,  "  I  do  not  see  how  to  explain  this  matter.' ' 
He  quotes  with  approval  from  a  Rabbi  of  old  who 
had  counselled  his  students,  "  teach  thy  tongue  to 
say,  I  do  not  know. ' '  In  this,  of  course,  he  has  given 
the  best  possible  evidence  of  his  largeness  of  mind 
and  his  capacity  for  making  advance  in  knowledge. 
It  is  when  men  are  ready  to  say,  "  I  do  not  know, ' ' 
that  progress  becomes  possible.  It  is  very  easy  to 
rest  in  a  conscious  or  unconscious  pretence  of  knowl- 
edge that  obscures  the  real  question  at  issue.  A  great 
thinker,  who  lived  in  the  century  in  which  Maimon- 
ides  died,  Roger  Bacon,  set  down  as  one  of  the 
four  principal  obstacles  to  advance  in  knowledge 
indeed,  as  the  one  of  the  four  that  hampered  intel- 
lectual progress  the  most,  the  fact  that  men  feared 
to  say,  "  I  do  not  know." 

One  of  the  most  interesting  features  of  Maimon- 
ides'  career  for  the  modern  time  is  the  influence  that 
his  writings  exerted  over  the  rising  intellectual  life 
of  Europe  within  a  half  century  after  his  death. 
Most  people  would  be  rather  inclined  to  think  that 
this  Jewish  author  of  the  East  would  have  very 
little  influence  over  the  thinkers  and  teachers  of 
Europe  within  a  generation  after  his  death.  He 
died  in  1204,  just  at  the  beginning  of  one  of  the 
great  productive  centuries  of  humanity,  perhaps 
one  of  the  greatest  of  them  all.  In  literature,  in 
art,  in  architecture,  in  philosophy,  and  in  educa- 
tion, this  century  made  wonderful  strides.  Two  of 
its  greatest  teachers,  Albertus  Magnus  and  his 
pupil,  Thomas  Aquinas,  quote  from  Moses  iEgyp- 


108  OLD-TIME  MAKEMS  OF  MEDICINE 

taeus,  the  European  name  for  Maimonides  at  that 
time,  and  evidently  knew  his  writings  very  well. 
Maimonides  was  for  them  an  important  connecting 
link  with  the  world  of  old  Greek  thought.  Others 
of  the  writers  and  teachers  of  this  time,  as  "William 
of  Auvergne,  and  the  two  great  Franciscans,  Alex- 
ander of  Hales  and  Duns  Scotus,  were  also  in- 
fluenced by  Maimonides.  In  a  word,  the  educa- 
tional world  of  that  time  was  much  more  closely 
united  than  we  might  think,  and  it  did  not  take 
long  for  a  great  writer's  thoughts  to  make  them- 
selves felt  several  thousand  miles  away.  Maimon- 
ides was,  then,  in  his  own  time  one  of  the  world 
teachers,  and,  in  a  certain  sense,  he  must  always  re- 
main that,  as  representing  a  special  development  of 
what  is  best  in  human  nature. 


V 

GEEAT  AEABIAN  PHYSICIANS 

In  order  to  understand  the  place  of  the  Arabs  in 
medicine  and  in  science,  a  few  words  as  to  the  rise 
of  this  people  to  political  power,  and  then  to  the  cul- 
tivation of  literature  and  of  science,  are  necessary. 
We  hear  of  the  Arabs  as  hireling*  soldiers  fighting 
for  others  during  the  centuries  just  after  Christ, 
and  especially  in  connection  with  the  story  of  the 
famous  Queen  Zenobia  at  Palmyra.  After  the  de- 
struction of  this  city  we  hear  nothing  more  of  them 
until  the  time  of  Mohammed.  During  these  six  and 
a  half  centuries  there  is  little  question  of  education 
of  any  kind  among  them  except  that  at  the  end  of 
the  sixth  century,  the  Persian  King  Chosroes  I, 
who  was  much  interested  in  medicine,  encouraged 
the  medical  school  in  Djondisabour,  in  Arabistan, 
founded  at  the  end  of  the  fifth  century  by  the  Nes- 
torian  Christians,  who  continued  as  the  teachers 
there  until  it  became  one  of  the  most  important 
schools  of  the  East.  It  was  here  that  the  first  Arab 
physicians  were  trained,  and  here  that  the  Chris- 
tian physicians  who  practised  medicine  among  the 
Arabs  were  educated. 

Among  the  Arabs  themselves,  before  the  time  of 
Mohammed,  there  had  been  very  little  interest  in 
medicine.  Gurlt  notes  that  even  the  physician  of 
the  Prophet  himself  was,  according  to  tradition,  a 

109 


110  OLD-TIME  MAKERS  OF  MEDICINE 

Christian.  Mohammed's  immediate  successors  were 
not  interested  in  education,  and  their  people  mainly 
turned  to  Christian  and  Jewish  physicians  for 
whatever  medical  treatment  they  needed.  "When 
the  Caliphs  came  to  be  rulers  of  the  Mohammedan 
Empire,  they  took  special  pains  to  encourage  the 
study  of  philosophy  and  medicine;  though  dissec- 
tion was  forbidden  by  the  Koran,  most  of  the  other 
medical  sciences,  and  especially  botany  and  all  the 
therapeutic  arts,  were  seriously  cultivated. 

Until  the  coming  of  Mohammed,  the  Arabs  had 
been  wandering  tribes,  getting  some  fame  as  hireling 
soldiers,  but  now,  under  the  influence  of  a  feeling 
of  community  in  religion,  and  led  by  the  military 
genius  of  some  of  Mohammed's  successors,  whose 
soldiers  were  inspired  by  the  religious  feelings  of 
the  sect,  they  made  great  conquests.  The  Moham- 
medan Empire  extended  from  India  to  Spain  within 
a  century  after  Mohammed's  death.  Carthage  was 
taken  and  destroyed,  Constantinople  was  threat- 
ened. In  661,  scarcely  forty  years  after  the  hegira 
or  flight  of  Mohammed,  from  which  good  Moham- 
medans date  their  era,  the  capital  was  transferred 
from  Medina  to  Damascus,  to  be  transferred  from 
here  to  Bagdad  just  about  a  century  later,  where  it 
remained  until  the  Mongols  made  an  end  of  the 
Abbasside  rulers  about  the  middle  of  the  thirteenth 
century.  At  the  beginning  the  followers  of  Mo- 
hammed were  opposed  to  knowledge  and  education 
of  all  kinds.  Mohammed  himself  had  but  little. 
According  to  tradition,  he  could  not  read  or  write. 
The  story  told  with  regard  to  the  Caliph  Omar  and 
the  great  library  of  Alexandria,  seems  to  have  a 


GREAT  ARABIAN  PHYSICIANS  111 

foundation  in  reality,  though  such  legends  usually 
are  not  to  be  taken  literally.  Certainly  it  represents 
the  traditional  view  as  to  the  attitude  of  the  earlier 
Moslem  rulers  to  education.  Omar  was  asked  what 
should  be  done  with  the  more  than  two  million  vol- 
umes. He  said  that  the  books  in  it  either  agreed 
with  the  Koran,  or  they  did  not.  If  they  agreed 
with  it  they  were  quite  useless.  If  they  did  not, 
they  were  pernicious.  In  either  case,  they  should 
be  done  away  with,  because  there  was  an  element  of 
danger  in  them.  Accordingly,  the  precious  volumes 
that  had  been  accumulating  for  nearly  ten  centuries, 
served,  it  is  said,  to  heat  the  baths  of  Alexandria 
for  some  six  months — probably  the  most  precious 
fuel  ever,  used.  Fortunately  for  posterity,  the  edict 
was  not  quite  as  universal  in  its  application  as  the 
story  would  indicate,  and  exceptions  were  made  for 
books  of  science. 

In  the  course  of  their  conquests,  however,  the 
Mohammedan  Arabs  captured  the  Greek  cities  of 
Asia  Minor.  They  were  brought  closely  in  contact 
with  Greek  culture,  Greek  literature,  and  Greek 
thought.  As  has  always  been  the  case,  captive 
Greece  took  its  captors  captive.  What  happened 
to  the  Eomans  earlier  came  to  pass  also  among  the 
Arabs.  Inspired  by  Greek  philosophy,  science,  and 
literature,  they  became  ardent  devotees  of  science 
and  the  arts.  While  not  inventing  or  discovering 
anything  new,  like  the  Romans  they  carried  on  the 
old.  Damascus,  Basra,  Bagdad,  Bokhara,  Samar- 
cand  all  became  centres  of  culture  and  of  educa- 
tion. Large  sums  were  paid  for  Greek  manu- 
scripts, and  for  translations  from  them.    Under  the 


112  OLD-TIME  MAKERS  OF  MEDICINE 

famous  Harun  al-Baschid,  at  the  end  of  the  eighth 
century,  whose  name  is  better  known  to  us  than  that 
of  any  others,  because  of  the  stories  of  his  wander- 
ing by  night  among  his  people  in  order  to  see  if 
justice  were  done,  three  hundred  scholars  were  sent 
at  the  cost  of  the  Caliph  to  the  various  parts  of  the 
world  in  order  to  bring  back  treasures  of  science, 
and  especially  of  geography  and  medicine.  It  is  an 
interesting  historical  reflection  that  the  Japanese 
and  Chinese  are  doing  the  same  thing  now. 

The  Arabs  were  very  much  taken  by  the  philoso- 
phy of  Aristotle,  and  it  became  the  foundation  of  all 
their  education.  Greek  thought,  as  always,  inspired 
its  students  to  higher  things.  Soon  everywhere  in 
the  dominions  of  the  Caliphs,  philosophy,  science, 
art,  literature,  and  education  flourished.  Medicine 
was  taken  up  with  the  other  sciences  and  cultivated 
assiduously.  Freind,  in  his  "  Historia  Medicinse," 
says  that  the  writings  of  the  old  Greeks  which 
treated  of  medicine  were  saved  from  destruction 
with  the  other  books  at  Alexandria,  for  the  desire 
of  health  did  not  have  less  strength  among  the  Arabs 
than  among  other  nations.  Since  these  books 
taught  them  how  to  preserve  health,  and  were  not 
otherwise  contrary  to  the  laws  of  the  Prophet,  that 
served  to  bring  about  their  preservation.  Freind 
also  calls  attention  to  the  fact  that  grammars  and 
books  which  treated  of  the  science  of  language  were 
likewise  saved  from  destruction.  Besides  the 
library,  the  Arabs,  after  their  conquest  of  Alex- 
andria in  the  eighth  century,  came  under  the  in- 
fluence of  the  university  still  in  existence  there. 

In  the  West,  in  Spain,  the  Arabs  enjoyed  the 


GEEAT  ARABIAN  PHYSICIANS  113 

same  advantages  as  regards  contact  with  culture 
and  education  as  their  conquest  of  the  Eastern 
cities  and  Alexandria  brought  them  in  the  East. 
While  it  is  not  generally  realized,  Spain  was,  as  we 
have  pointed  out,  the  province  of  the  Eoman  Em- 
pire in  the  West  that  advanced  most  in  culture  be- 
fore the  breaking  up  of  the  Empire.  The  Silver 
Age  of  Latin  literature  owes  all  of  its  geniuses  to 
Spain.  Lucan,  the  Senecas,  Martial,  Quintilian, 
are  all  Spaniards.  Spain  itself  was  a  most  flourish- 
ing province,  and  under  the  Spanish  Caesars,  from 
the  end  of  the  first  to  about  the  end  of  the  second 
century,  increased  rapidly  in  population.  Spain 
was  the  leader  in  these  prosperous  times,  and  the 
tradition  of  culture  maintained  itself.  When 
Spain  became  Christian  the  first  great  Christian 
poet,  Prudentius,  born  about  the  middle  of  the 
fourth  century,  came  from  there.  He  has  been 
called  the  Horace  and  Virgil  of  the  Christians. 

The  coming  down  of  the  barbarians  from  the 
North  disturbed  Spain's  prosperity  and  the  peace 
and  culture  of  her  inhabitants,  but  it  should  not  be 
forgotten  that  the  first  medieval  popularization  of 
science,  a  sort  of  encyclopedia  of  knowledge,  the 
first  of  its  kind  after  that  of  Pliny  in  the  classical 
period,  came  from  St.  Isidore  of  Seville,  a  Spanish 
bishop. 

There  has  been  considerable  tendency  to  insist 
that  Spanish  culture  and  intellectuality  owe  nearly 
all  to  the  presence  of  the  Moors  in  Spain.  This  can 
only  be  urged,  however,  by  those  who  know  nothing 
at  all  of  the  Spanish  Caesars,  the  place  of  Spain  in 
the  history  of  the  Roman  Empire,  and  the  continu- 


114  OLD-TIME  MAKERS  OF  MEDICINE 

ance  of  the  culture  that  then  reached  a  climax  of 
expression  during  succeeding  centuries.  On  the 
contrary,  the  Moors  who  came  to  Spain  owe  most 
of  their  tendency  to  devote  themselves  to  culture 
and  education  to  the  state  of  affairs  existent  in 
Spain  when  they  came.  There  is  no  doubt  that 
they  raised  standards  of  education  and  of  culture 
above  the  level  to  which  they  had  sunk  under  the 
weight  of  the  invading  barbarians  from  the  North, 
and  Spain  owes  much  to  the  wise  ruling  and  devo- 
tion to  the  intellectual  life  of  her  Moorish  invaders. 
All  the  factors,  however,  must  be  taken  together  in 
order  to  appreciate  properly  the  conditions  which 
developed  under  the  Arabs  in  both  the  East  and  the 
West.  The  Arabs  invented  little  that  was  new  in 
science  or  philosophy ;  they  merely  carried  on  older 
traditions.  It  is  for  that  that  the  modern  time 
owes  them  a  great  debt  of  gratitude. 

RHAZES 

The  most  distinguished  of  the  Arabian  physicians 
was  the  man  whose  rather  lengthy  Arabian  name, 
beginning  with  Abu  Bekr  Mohammed,  finished  with 
el-Eazi,  and  who  has  hence  been  usually  referred 
to  in  the  history  of  medicine  as  Ehazes.  He  was 
born  about  850  at  Eaj,  in  the  Province  of  Chorasan 
in  Persia.  He  seems  to  have  had  a  liberal  early 
education  in  philosophy  and  in  philology  and  litera- 
ture. He  did  not  take  up  medicine  until  later  in 
life,  and,  according  to  tradition,  supported  himself 
as  a  singer  until  he  was  thirty  years  of  age.  Then 
he   devoted  himself  to  medical   studies  with  the 


GREAT  ARABIAN  PHYSICIANS  115 

ardor  and  the  success  so  often  noted  in  those  whose 
opportunity  to  study  medicine  has  been  delayed. 
His  studies  were  made  at  Bagdad,  where  Ibn  Zein 
el-Taberi  was  his  teacher.  He  returned  to  his  na- 
tive town  and  was  for  some  time  the  head  of  the 
hospital  there.  Later  he  was  called  by  the  Sultan  to 
Bagdad  to  take  charge  of  the  renovated  and  en- 
larged hospital  of  the  capital.  His  medical  career, 
then,  is  not  unlike  that  of  many  another  successful 
physician,  especially  of  the  modern  time.  At 
Bagdad  he  had  abundant  opportunities  for  study, 
and  the  ambition  to  make  medicine  as  well  as  to 
make  money  and  gain  fame. 

His  studies  in  science  were  all  founded  on  Aris- 
totle. Though  he  was  called  the  Galen  of  his  time, 
and  looked  up  to  the  Greek  physician  as  his  master, 
even  the  authority  of  Galen  did  not  override  that  of 
the  Stagirite  in  his  estimation.  One  of  his  apho- 
risms is  said  to  have  been,  "  If  Galen  and  Aristotle 
are  of  one  mind  on  a  subject,  then  surely  their 
opinion  is  true.  When  they  differ,  however,  it  is 
extremely  difficult  for  the  scholar  to  decide  which 
opinion  should  be  accepted. ' '  He  drew  many  pupils 
to  Bagdad,  and,  when  one  knows  his  teaching,  this 
is  not  surprising.  Some  of  his  aphorisms  are  very 
practical.  While  the  expressions  just  quoted  with 
regard  to  Galen  and  Aristotle  might  seem  to  in- 
dicate that  Ehazes  was  absolutely  wedded  to  author- 
ity, there  is  another  well-known  maxim  of  his  which 
shows  how  much  he  thought  of  the  value  of  experi- 
ence and  observation.  "  Truth  in  medicine,"  he 
said,  "  is  a  goal  which  cannot  be  absolutely  reached, 
and  the  art  of  healing,  as  it  is  described  in  books, 


116  OLD-TIME  MAKERS  OF  MEDICINE 

is  far  beneath  the  practical  experience  of  a  skilful, 
thoughtful  physician."  Some  of  his  other  medical 
aphorisms  are  worth  noting.  ' '  At  the  beginning  of 
a  disease  choose  such  remedies  as  will  not  lessen 
the  patient's  strength.' '  "  When  you  can  heal  by 
diet,  prescribe  no  other  remedy,  and,  where  simple 
remedies  suffice,  do  not  take  complicated  ones." 

Ehazes  knew  well  the  value  of  the  influence  of 
mind  over  body  even  in  serious  organic  disease,  and 
even  though  death  seemed  impending.  One  of  his 
aphorisms  is :  "  Physicians  ought  to  console  their 
patients  even  if  the  signs  of  impending  death  seem 
to  be  present.  For  the  bodies  of  men  are  dependent 
on  their  spirits."  He  considered  that  the  most 
valuable  thing  for  the  physician  to  do  was  to  in- 
crease the  patient's  natural  vitality.  Hence  his  ad- 
vice: "  In  treating  a  patient,  let  your  first  thought 
be  to  strengthen  his  natural  vitality.  If  you 
strengthen  that,  you  remove  ever  so  many  ills  with- 
out more  ado.  If  you  weaken  it,  however,  by  the 
remedies  that  you  use  you  always  work  harm." 
The  simpler  the  means  by  which  the  patient's  cure 
can  be  brought  about,  the  better  in  his  opinion.  He 
insists  again  and  again  on  diet  rather  than  artificial 
remedies.  "It  is  good  for  the  physician  that  he 
should  be  able  to  cure  disease  by  means  of  diet,  if 
possible,  rather  than  by  means  of  medicine."  An- 
other of  his  aphorisms  seems  worth  while  quoting: 
' i  The  patient  who  consults  a  great  many  physicians 
is  likely  to  have  a  very  confused  state  of  mind. ' ' 

Some  idea  of  Ehazes'  strenuous  activity  as  a 
writer  on  medical  subjects  may  be  obtained  from 
the  fact  that  thirty-six  of  his  works  are  still  extant, 


GHEAT  ARABIAN  PHYSICIANS  117 

and  there  are  nearly  two  hundred  others  of  which 
only  the  titles  have  been  preserved.  Some  of  these 
are  doubtless  the  works  of  pupils  and  students  of 
succeeding  generations,  published  under  his  name 
to  attract  attention.  His  principal  work  is  "  Con- 
tineus,"  or  "  Comprehensor, '  *  which  owes  its  title 
to  the  fact  that  it  was  meant  to  contain  the  whole 
practice  of  medicine  and  surgery.  It  includes 
references  to  the  writings  of  all  previous  distin- 
guished medical  writers,  from  Hippocrates  to 
Honein  Ben  Ishac,  also  known  as  Johannitius,  a 
Christian  Arabian  physician,  one  of  Ehazes'  teach- 
ers. The  most  frequently  quoted  of  these  authori- 
ties are  Galen,  Oribasius,  Aetius,  and  Paul  of  iEgina. 
The  work,  however,  is  not  made  up  entirely  of  quo- 
tations, but  contains  many  observations  made  by  the 
author  himself.  Gurlt  says  that  the  foundation  of 
the  theoretic  medicine  of  Ehazes  is  the  system  of 
Galen,  while  in  practice  he  seems  to  cling  more  to 
the  aphorisms  of  Hippocrates.  He  has  many  prac- 
tical points  which  show  that  he  thought  for  himself. 
For  instance,  in  wounds  of  the  abdomen,  if  the  in- 
testines are  extruded  and  cannot  be  replaced,  he 
suggests  the  suspension  of  the  patient  by  his  hands 
and  feet  in  a  bath  in  order  to  facilitate  their  return. 
If  they  do  not  go  back  readily,  compresses  dipped  in 
warm  wine  should  be  used.  Cancer  he  declares  to 
be  almost  incurable.  He  has  much  to  say  about  the 
bites  of  animals  and  their  tendency  to  be  poisonous, 
knew  rabies  very  well,  and  knew  also  that  the 
bites  of  men  might  have  similar  serious  conse- 
quences. 

It  is  impossible  to  give  any  adequate  idea  of  the 


118  OLD-TIME  MAKERS  OF  MEDICINE 

thoroughly  practical  character  of  Rhazes'  medical 
writing  in  a  few  lines,  but  it  may  suffice  to  say  that 
there  is  scarcely  any  feature  of  modern  medicine 
and  surgery  that  he  does  not  touch,  and  oftener  than 
not  his  touch  is  sure  and  rational  and  frequently 
much  better  than  the  advice  of  successors  long  after 
him  in  the  same  matters.  An  example  or  two  will 
suffice  to  illustrate  this.  In  the  treatment  of  nasal 
polyps  he  says  that  whenever  drug  treatment  of 
these  is  not  successful,  they  should  be  removed  with 
a  snare  made  of  hair.  For  fall  of  the  uvula  he  sug- 
gests gargles,  but  when  these  fail  he  advises  re- 
section and  cauterization.  Among  the  affections  of 
the  tongue  he  numbers  abscess,  fissure,  ulcer,  can- 
cer, ranula,  shortening  of  the  ligaments,  hypertro- 
phy, erythema  of  the  mucous  membrane,  and  in- 
flammatory swelling.  In  general  his  treatment  of 
the  upper  respiratory  tract  is  much  farther  ad- 
vanced than  we  might  think  possible  at  this  time. 
He  advises  tracheotomy  whenever  there  is  great  dif- 
ficulty of  respiration,  and  describes  how  it  should 
be  done.  After  the  dyspnea  has  passed  the  edges 
of  the  wound  should  be  brought  together  with 
sutures.  It  is  not  surprising,  then,  to  find  that  the 
treatment  of  fractures  and  luxations  is  eminently 
practical,  and,  indeed,  on  any  subject  that  he  touches 
he  throws  practical  light. 

In  the  introduction  to  his  edition  of  the  works  of 
Ambroise  Pare,  Malgaigne  says  that  the  first  refer- 
ence to  a  metal  band  in  connection  with  trusses  is 
to  be  found  in  Rhazes.  Hernia  was,  of  course,  one 
of  the  serious  ailments  that,  because  of  its  super- 
ficial character,  was  rather  well  understood,  and  so 


GREAT  ARABIAN  PHYSICIANS  119 

it  is  not  surprising  to  find  that  much  of  our  modern 
treatment  of  it  was  anticipated.  The  manipulations 
for  taxis,  the  use  of  a  warm  bath  for  the  relaxation 
of  the  patient  by  means  of  heat  and  by  putting  the 
head  and  feet  higher  than  the  abdomen  while  in  the 
bath,  and  the  employment  of  various  kinds  of  trusses 
to  prevent  strangulation  of  the  hernia  recur  over 
and  over  again,  in  the  authors  of  the  Middle  Ages. 
Many  of  the  suggestions  are  to  be  found  in  the  early 
Greek  authors,  but  subsequent  writers  give  a  cer- 
tain personal  expression  to  them  which  shows  how 
much  they  had  learned  by  personal  observation  in 
the  employment  of  various  methods. 

Pagel,  in  Puschmann's  "  Handbook  of  the  His- 
tory of  Medicine,"  declares  that  Rhazes'  most  im- 
portant work  for  pure  medicine  is  his  monograph  on 
smallpox.  Its  principal  value  is  due  to  the  fact 
that,  though  he  has  consulted  old  authorities  care- 
fully, his  discussion  of  the  disease  is  founded  al- 
most entirely  on  his  own  experience.  His  descrip- 
tion of  the  various  stages  of  the  disease,  of  the  forms 
of  the  eruption,  and  of  the  differential  diagnosis,  is 
very  accurate.  He  compares  the  course  of  the  fever 
with  that  of  other  fevers,  and  brings  out  exactly 
what  constitutes  the  disease.  His  suggestions  as 
to  prognosis  are  excellent.  Those  cases,  he  de- 
clares, are  particularly  serious  in  which  the  erup- 
tion takes  on  a  dark,  or  greenish,  or  violet  color. 
The  prognosis  is  also  unfavorable  for  those  cases 
which,  having  considerable  fever,  have  only  a  slight 
amount  of  rash.  His  treatment  of  the  disease  in 
young  persons  was  by  venesection  and  cool  douches. 
Cold  ^ater  and  acid  drinks  should  be  administered 


120  OLD-TIME  MAKERS  OF  MEDICINE 

freely,  so  that  sweat  and  other  excretions  may  carry 
off  poisonous  materials.  Care  must  be  taken  to 
watch  the  pulse,  the  breathing,  the  appearance  of 
the  feet,  the  evacuations  from  the  bowels,  and  to 
modify  therapy  in  accordance  with  these  indications. 
The  eruption  is  to  be  encouraged  by  external  warmth 
and  special  care  must  be  taken  with  regard  to  com- 
plications in  the  eyes,  the  ears,  the  nose,  the  mouth, 
and  the  pharynx. 

A  fact  that  will,  perhaps,  give  the  best  idea  to 
modern  readers  of  the  place  of  Ehazes  in  the  his- 
tory of  medicine  is  that  Vesalius  considered  it  worth 
his  while  to  make  a  translation  of  his  principal  work. 
Unfortunately  that  translation  has  not  come  down 
to  us.  When  Vesalius,  pestered  by  the  con- 
troversies that  had  come  upon  him  because  of  his 
venturing  to  make  his  observations  for  himself,  ac- 
cepted the  post  of  physician  to  the  Emperor  Charles 
V,  he  burnt  a  number  of  his  manuscripts. 
Among  these  were  his  translation  of  Ehazes  and 
some  annotations  on  Galen,  which,  as  he  says  him- 
self, had  grown  into  a  huge  volume.  The  G-alenists 
were  bitterly  decrying  his  refusal  to  accept  G-alen 
on  many  points,  and  both  of  these  works  would  have 
added  fuel  to  the  flame  of  controversy.  He  deemed 
it  wiser,  then,  not  to  give  any  further  opportunities 
for  rancorous  criticism,  and,  feeling  presumably 
that  in  his  new  and  important  post  it  was  not  worth 
while  to  bother  further  over  the  matter,  he  burnt 
them.  He  tells  the  reason  in  his  letters  to  Joachin 
Eoelant :  ' '  When  I  was  about  to  leave  Italy  to  go 
to  Court,  since  a  number  of  the  physicians  whom 
you  know  had  made  the  worst  kind  of  censure  of 


GREAT  ARABIAN  PHYSICIANS  121 

my  books,  both  to  the  Emperor  himself,  and  to  other 
rulers,  I  burned  all  the  manuscripts  that  were  left, 
although  I  had  never  suffered  a  moment  under  the 
displeasure  of  the  Emperor  because  of  these  com- 
plaints, and  in  spite  of  the  fact  that  a  number  of 
friends  who  were  present  urged  me  not  to  destroy 
them. ' ' 

Vesalius '  translation  of  Ehazes  was  probably  un- 
dertaken because  he  recognized  in  him  a  kindred 
spirit  of  original  investigation  and  inquiry,  whose 
work,  because  it  was  many  centuries  old,  would 
command  the  weight  of  an  authority  and  at  the  same 
time  help  in  the  controversy  over  Galenic  questions. 
This,  of  itself,  would  be  quite  enough  to  make  the 
reputation  of  Ehazes,  even  if  we  did  not  know  from 
the  writings  themselves  and  from  the  admiration  of 
many  distinguished  men  as  well  as  the  incentive  that 
his  works  have  so  often  proved  to  original  ob- 
servation, that  he  is  an  important  link  in  the  chain 
of  observers  in  medicine,  who,  though  we  would 
naturally  expect  them  to  be  so  frequent,  are  really 
so  rare. 

ALI  ABBAS 

Ehazes  lived  well  on  into  the  tenth  century.  His 
successor  in  prestige,  though  not  his  serious  rival, 
was  Ali  Ben  el-Abbas,  usually  spoken  of  in  medical 
literature  as  Ali  Abbas,  a  distinguished  Arabian 
physician  who  died  near  the  end  of  the  tenth  cen- 
tury. He  wrote  a  book  on  medicine  which,  because 
of  its  dedication  to  the  Sultan,  to  whom  he  was  body- 
physician,  is  known  as  the  "  Liber  Eegius,"  or 


122  OLD-TIME  MAKERS  OF  MEDICINE 

"  Eoyal  Book  of  Medicine."  This  became  the  lead- 
ing text-book  of  medicine  for  the  Arabs  until  re- 
placed by  the  ' '  Canon  of  Avicenna  ' '  some  two  cen- 
turies later.  The  "  Liber  Regius  "  was  an  ex- 
tremely practical  work  and,  like  most  of  the  Arabian 
books  of  the  early  times,  is  simple  and  direct,  quite 
without  many  of  the  objectionable  features  that  de- 
veloped later  in  Arabian  medicine.  It  is  valuable 
mainly  for  its  contributions  to  diet  and  the  fact 
that  Ali  Abbas  tested  many  of  his  medicines  on  ail- 
ing animals  before  applying  them  to  men.  Of 
course,  it  owes  much  to  earlier  writers  on  medicine, 
and  especially  to  Paul  of  ^Egina. 

An  example  of  its  practical  value  is  to  be  found 
in  his  description  of  the  treatment  of  a  wound  of 
the  brachial  artery,  when,  as  happened  often  in 
venesection  from  the  median  basilic  vein,  it  was  in- 
jured through  carelessness  or  inadvertence.  If 
astringent  or  cauterizing  methods  do  not  stop  the 
bleeding,  the  artery  should  be  exposed,  carefully 
isolated,  tied  in  two  places  above  and  below  the 
wound,  and  then  cut  across  between  them.  He  has 
many  similar  practical  bits  of  technique.  For  in- 
stance, in  pulling  a  back  tooth  he  recommends  that 
the  gums  be  incised  so  as  to  loosen  them  around 
the  roots,  and  then  the  tooth  itself  may  be  drawn 
with  a  special  forceps  which  he  calls  a  molar  forceps. 
In  ascites  he  recommends  that  when  other  means 
fail  an  opening  should  be  made  three  finger-breadths 
below  the  navel  with  a  pointed  phlebotomy  knife, 
and  a  portion  of  the  fluid  allowed  to  evacuate  itself. 
A  tube  should  then  be  inserted,  but  closed.  The 
next  day  more  of  the  fluid  should  be  allowed  to 


GREAT  ARABIAN  PHYSICIANS  123 

come  away,  and  then  the  tube  removed  and  the  ab- 
domen wrapped  with  a  firm  bandage. 

It  is  easy  to  understand  that  Ali  Abbas'  book 
should  have  been  popular,  and  the  more  we  know 
of  it  the  easier  it  is  to  explain  why  Constantine 
Africanus  should  have  selected  it  for  translation. 
It  contains  ten  theoretic  and  ten  practical  books,  and 
gives  an  excellent  idea  of  the  medical  knowledge  and 
medical  practice  of  the  time.  Probably  the  fact 
that  Constantine  had  translated  it  led  to  its  early 
printing,  so  that  we  have  an  edition  of  it  published 
at  Venice  in  1492,  and  another  at  Lyons  in  1523. 
During  the  Middle  Ages  the  book  was  often  spoken 
of  as  "  Eegalis  Dispositio, ' '  the  "  Royal  Disposi- 
tion of  Medicine. ' ' 


MOORISH  PHYSICIANS 

After  Rhazes,  the  most  important  contributors  to 
medical  literature  from  among  the  Arabs,  with  the 
single  exception  of  Avicenna,  were  born  in  Spain. 
They  are  Albucasis  or  Abulcasis,  the  surgeon; 
Avenzoar,  the  physician,  and  Averroes,  the  philo- 
sophic theorist  in  medicine.  Besides,  it  may  be  re- 
called here  that  Maimonides,  the  great  Jewish  physi- 
cian, was  born  and  educated  at  Cordova,  in  Spain. 
It  might  very  well  be  a  surprise  that  these  distin- 
guished men  among  the  Arabs  should  have  flour- 
ished in  Spain,  so  far  from  the  original  seat  of 
Arabian  and  Mohammedan  dominion  in  the  East, 
where,  owing  to  conditions  in  the  modern  time,  the 
English-speaking  world  particularly  is  not  likely  to 
assume  that  the  environment  was  favorable  for  the 


124  OLD-TIME  MAKERS  OF  MEDICINE 

development  of  science  and  philosophy.  Anyone 
who  recalls,  however,  the  history  of  Spanish  in- 
tellectual influence  in  the  Eoman  Empire,  as  we 
have  traced  it  at  the  beginning  of  this  chapter,  will 
appreciate  how  favorable  conditions  were  in  Spain 
for  the  fostering  of  intellectual  development.  With 
the  disturbances  that  had  come  from  political  strife 
and  the  invasion  of  the  barbarians  in  Italy,  Spain 
had  undoubtedly  come  to  hold  the  primacy  in  the  in- 
tellectual life  of  Europe  at  the  time  when  the  Arabs 
took  possession  of  the  peninsula. 

ABULCASIS 

The  most  important  of  the  Arabian  surgeons  of 
the  Middle  Ages  is  Albucasis  or  Abulcasis,  also 
Abulkasim,  who  was  born  near  Cordova,  in  Spain. 
The  exact  year  of  his  birth  is  not  known,  but  he 
flourished  in  the  second  half  of  the  tenth  century. 
He  is  said  to  have  lived  to  the  age  of  101.  The 
name  of  his  principal  work,  which  embraces  the 
whole  of  medicine,  is  "  Altasrif,"  or  "  Tesrif," 
which  has  been  translated  i '  The  Miscellany. ' '  Most 
of  what  he  has  to  say  about  medical  matters  is 
taken  from  Ehazes.  His  work  on  surgery,  however, 
in  three  books,  represents  his  special  contribution 
to  the  medical  sciences.  It  contains  a  number  of  il- 
lustrations of  instruments,  and  is  the  first  illustrated 
medical  book  that  has  come  to  us.  It  was  translated 
into  Latin,  and  was  studied  very  faithfully  by  all 
the  surgeons  of  the  Middle  Ages.  G-uy  de  Chauliac 
has  quoted  Albucasis  about  two  hundred  times  in 
his  "  Chirurgia  Magna.' '    Even  as  late  as  the  be- 


GREAT  ARABIAN  PHYSICIANS  125 

ginning  of  the  sixteenth  century  Fabricius  de  Ac- 
quapendente,  the  teacher  of  Harvey,  confessed  that 
he  owed  most  to  three  great  medical  writers,  Celsus 
(first  century),  Paul  of  iEgina  (seventh  century), 
and  Abulcasis  (tenth  century). 

Abulcasis  insisted  that  for  successful  surgery  a 
detailed  knowledge  of  anatomy  was,  above  all,  neces- 
sary. He  said  that  the  reason  why  surgery  had 
declined  in  his  day  was  that  physicians  did  not 
know  their  anatomy.  The  art  of  medicine,  he  added 
further,  required  much  time.  Unfortunately,  to 
quote  Hippocrates,  there  are  many  who  are  physi- 
cians in  name  only,  and  not  in  fact,  especially  in 
what  regards  surgery.  He  gives  some  examples  of 
surgical  mistakes  made  by  his  professional  brethren 
that  were  particularly  called  to  his  attention.  They 
are  the  perennially  familiar  instances  of  ignorance 
causing  death  because  surgeons  were  tempted  to 
operate  too  extensively. 

His  description  of  the  procedure  necessary  to 
stop  an  artery  from  bleeding  is  an  interesting  ex- 
ample of  his  method  of  teaching  the  practical  tech- 
nique of  surgery.  Apply  the  finger  promptly  upon 
the  opening  of  the  vessel  and  press  until  the  blood 
is  arrested.  Having  heated  a  cautery  of  the  ap- 
propriate size,  take  the  finger  away  rapidly  and 
touch  the  cautery  at  once  to  the  end  of  the  artery 
until  the  blood  stops.  If  the  spurting  blood  should 
cool  the  cautery,  take  another.  There  should  be 
several  ready  for  the  purpose.  Take  care,  he  says, 
not  to  cauterize  the  nerves  in  the  neighborhood,  for 
this  will  add  a  new  ailment  to  the  patient's  affec- 
tion.    There  are  only  four  ways  of  arresting  arterial 


126  OLD-TIME  MAKERS  OF  MEDICINE 

hemorrhage.  First,  by  cautery ;  second,  by  division 
of  the  artery,  when  that  is  not  complete — for  then 
the  extremities  contract  and  the  blood  clots — or  by 
a  ligature,  or  by  the  application  of  substances  which 
arrest  blood  flow,  aided  by  a  compressive  bandage. 
Other  means  are  inefficient,  and  seldom  and,  at  most, 
accidentally  successful.  His  instruction  for  first 
aid  to  the  injured  in  case  of  hemorrhage  in  the  ab- 
sence of  the  physician,  is  to  apply  pressure  directly 
upon  the  wound  itself. 

The  development  of  the  surgical  specialties  among 
the   Arabs   is   particularly   interesting.    Abulcasis 
has  much  to  say  about  nasal  polyps.    He  divided 
them  into  three  classes:   (1)   cancerous,   (2)   those 
with  a  number  of  feet,  and  (3)  those  that  are  soft 
and  not  living, — these  latter,  he  says,  are  neither 
malignant  nor  difficult  to  treat.    He  recommends 
the  use  of  a  hook  for  their  removal,  or  a  snare  for 
those  that  cannot  be  removed  with  that  instrument. 
His  instructions  for  the  removal  of  objects  from  the 
external  ear  are  interestingly  practical.    He   ad- 
vises the  use  of  bird  lime  on  the  end  of  a  sound  to 
which  objects  will  cling,  or,  where  they  are  smaller, 
suction  through  a  silver  or  copper  canula.    Hooks 
and  pincettes  are  also  suggested.    Insects  should  be 
removed  with  a  hook,  or  with  a  canula,  or,  having 
been  killed  by  warm  oil,  removed  by  means  of  a 
syringe.     Some  of  his  observations  with  regard  to 
genito-urinary  surgery  are  quite  as  interesting.   He 
even  treated  congenital  anomalies.  He  suggests  cut- 
ting of  the  meatus  when  narrowed,  dilatation  of 
strictures  with  lead  sounds,  and  even  suggests  plans 
of  operations  to  improve  the  condition  in  hypo- 


GREAT  ARABIAN  PHYSICIANS  127 

spadias.  He  gives  the  signs  for  differentiation  be- 
tween epitheliomata  and  condylomata,  and  distin- 
guishes various  forms  of  ulceration  of  the  penis. 

Abulcasis  discusses  varicose  veins  in  very  much 
the  same  spirit  as  a  modern  surgeon  does.  They 
occur  particularly  in  people  who  work  much  on 
their  feet,  and  especially  who  have  to  carry  heavy 
burdens.  They  should  not  be  operated  on  unless 
they  produce  great  discomfort,  and  make  it  impos- 
sible for  the  sufferer  to  make  his  living.  They  may 
be  operated  on  by  means  of  incision  or  extirpation. 
Incision  consists  of  cutting  the  veins  at  two  or  three 
places  when  they  have  been  made  prominent  by 
means  of  tight  bandages  around  the  limb.  The  blood 
should  be  allowed  to  flow  freely  out  of  the  cut  ends, 
and  then  a  bandage  applied.  For  extirpation,  the 
skin  having  been  shaved  beforehand,  the  vein  should 
be  made  prominent,  and  then  carefully  laid  bare. 
When  freed  from  all  adhesions,  it  should  be  lifted 
out  on  a  hook,  and  either  completely  extirpated  or 
several  rather  long  pieces  removed.  He  lays  a  good 
deal  of  stress  on  the  necessity  for  freeing  the  vein 
thoroughly  and  lifting  it  well  out  of  tissues  before 
incising  it.  In  old  cases  special  care  must  be  taken 
not  to  tear  the  vein. 

Minute  details  of  technique  are  often  found  in 
these  old  authors.  Abulcasis,  for  instance,  treats  of 
adherent  fingers  with  up-to-date  completeness.  They 
can  occur  either  congenitally  or  from  injury,  as,  for 
instance,  burning.  They  should  be  separated,  and 
then  separation  maintained  by  means  of  bandages 
or  by  the  insertion  between  them  of  a  thin  lead  plate, 
which  prevents  their  readhesion.    Adhesions  of  the 


128  OLD-TIME  MAKERS  OF  MEDICINE 

fingers  with  the  palm  of  the  hand,  which  Abulcasis 
has  also  seen,  should  be  treated  the  same  way. 

At  times  there  is  surprise  at  finding  some  rare 
lesion  treated  with  modern  technique,  and  a  hint 
at  least  of  our  modern  apparatus.  Fracture  of  the 
pubic  arch,  for  instance,  is  described  in  Abulcasis 
quite  as  if  he  had  had  definite  experience  with  it. 
When  this  occurs  in  a  woman,  the  reposition  of 
the  bone  is  often  greatly  facilitated  by  a  cotton 
tampon  in  the  vagina.  This  tampon  must  be  re- 
moved at  every  urination.  There  is  another  way, 
however,  of  better  securing  the  same  purpose  of 
counterpressure.  One  may  take  a  sheep's  bladder 
into  the  orifice  of  which  a  tube  is  fastened.  One 
should  introduce  the  bladder  into  the  vagina,  and 
then  blow  strongly  through  the  tube,  until  the  blad- 
der becomes  swollen  and  fills  up  the  vaginal  cavity. 
The  fracture  will,  as  a  rule,  then  be  readily  re- 
duced. Here  is,  of  course,  not  alone  the  first  hint 
of  the  colpeurynter,  but  a  very  practical  form  of 
the  apparatus  complete.  Old-time  physicians  used 
the  bladders  of  animals  very  generally  for  nearly 
all  the  medical  purposes  for  which  we  now  use  rub- 
ber bags. 

AVICENNA 

Undoubtedly  the  most  important  of  Abulcasis' 
contemporaries  is  the  famous  physician  whose 
Arabic  name,  Ibn  Sina,  was  transformed  into  Avi- 
cenna.  He  was  born  toward  the  end  of  the  tenth 
century  in  the  Persian  province  of  Chora san,  at  the 
height  of  Arabian  influence,  and  is  sometimes  spoken 


GREAT  ARABIAN  PHYSICIANS  129 

of  as  the  chief  representative  of  Arabian  medicine, 
of  as  much  importance  for  it  as  Galen  for  later 
Greek  medicine.  His  principal  book  is  the  so-called 
"  Canon."  It  replaced  the  compendinm  "  Con- 
tinens  "  of  Rhazes,  and,  in  the  East,  continued  un- 
til the  end  of  the  fifteenth  century  to  be  looked  upon 
as  the  most  complete  and  best  system  of  medicine. 
Avicenna  came  to  be  better  known  in  the  West  than 
any  of  the  other  Arabian  writers,  and  his  name  car- 
ried great  weight  with  it.  There  are  very  few  sub- 
jects in  medicine  that  did  not  receive  suggestive,  if 
not  always  adequate,  treatment  at  the  hands  of  this 
great  Arabian  medical  thinker  of  the  eleventh  cen- 
tury. He  copied  freely  from  his  predecessors,  but 
completed  their  work  with  his  own  observations  and 
conclusions.  One  of  his  chapters  is  devoted  to 
leprosy  alone.  He  has  definite  information  with  re- 
gard to  bubonic  plague  and  the  filaria  medinensis. 
Here  and  there  one  finds  striking  anticipations  of 
what  are  supposed  to  be  modern  observations. 
Nothing  was  too  small  for  his  notice.  One  portion 
of  the  fourth  book  is  on  cosmetics,  in  which  he 
treats  the  affections  of  the  hair  and  of  the  nails. 
He  has  special  chapters  with  regard  to  obesity, 
emaciation,  and  general  constitutional  conditions. 
His  book,  the  '  *  Antidotarium, ' '  is  the  foundation  of 
our  knowledge  of  the  drug-giving  of  his  time. 

Some  idea  of  the  popularity  and  influence  of  Avi- 
cenna, five  centuries  after  his  time,  can  be  readily 
derived  from  the  number  of  commentaries  on  him 
issued  during  the  Renaissance  period  by  the  most 
distinguished  medical  scholars  and  writers  of  that 
time.    Hyrtl,  in  his  "  Das  Arabische  und  Hebraische 


130  OLD-TIME  MAKERS  OF  MEDICINE 

in  der  Anatomie,"  quotes  some  of  them, — Bartholo- 
maeus  de  Varignana,  Gentilis  de  Fulgineis,  Jacobus 
de  Partibus,  Didacus  Lopez,  Jacobus  de  Forlivio, 
Ugo  Senesis,  Dinus  de  Garbo,  Matthaeus  de  Gradi- 
bus,  Nicolaus  Leonicenus,  Thaddaeus  Florentinus, 
Galeatus  de  Sancta  Sophia.  A  more  complete  list, 
with  the  titles  of  the  books,  may  be  found  in  Haller's 
"  Bibliotheca  Anatomica."  For  over  three  cen- 
turies after  the  foundation  of  medical  schools  in 
Europe  (and  even  after  Mondino's  book  had  been 
widely  distributed),  Avicenna  was  still  in  the  hands 
of  all  those  who  had  an  enthusiasm  for  medical 
science. 

AVENZOAR 

Another  of  the  distinguished  Arabian  physicians 
was  Avenzoar — the  transformation  of  his  Arabic 
family  name,  Ibn-Zohr.  He  was  probably  born  in 
Penaflor,  not  far  from  Seville.  He  died  in  Seville 
in  1162  at  the  age,  it  is  said,  of  ninety-two  years. 
He  was  the  son  of  a  physician  descended  from  a 
family  of  scholars,  jurists,  physicians,  and  officials. 
He  received  the  best  education  of  the  time  not  only 
in  internal  medicine,  but  in  all  the  specialties,  and 
must  be  counted  among  the  greatest  of  the  Spanish 
Arabian  physicians.  He  was  the  teacher  of  Aver- 
roes,  who  always  speaks  of  him  with  great  respect. 
He  is  interesting  as  probably  being  the  first  to  sug- 
gest nutrition  per  rectum.  A  few  words  of  his 
description  show  how  well  he  knew  the  technique. 
His  apparatus  for  the  purpose  consisted  of  the 
bladder  of  a  goat  or  some  similar  animal  structure, 


GREAT  ARABIAN  PHYSICIANS  131 

with  a  silver  canula  fastened  into  its  neck,  to  be 
used  about  as  we  use  a  fountain  syringe.  Having 
first  carefully  washed  out  the  rectum  with  cleansing 
and  purifying  clysters,  he  injected  the  nutriment — 
eggs,  milk,  and  gruels — into  the  gut.  His  idea  was 
that  the  intestine  would  take  this,  and,  as  he  said, 
suck  it  up,  carrying  it  back  to  the  stomach,  where  it 
would  be  digested.  He  was  sure  that  he  had  seen 
his  patients  benefited  by  it. 

Some  light  on  his  studies  of  cases  that  would  re- 
quire such  treatment  may  be  obtained  from  what 
he  has  to  say  about  the  handling  of  a  case  of 
stricture  of  the  esophagus.  He  says  that  this  be- 
gins with  some  discomfort,  and  then  some  difficulty 
of  swallowing,  which  is  gradually  and  continuously 
increased  until  finally  there  comes  complete  impos- 
sibility of  swallowing.  It  was  in  these  cases  that 
he  suggested  rectal  alimentation,  but  he  went 
farther  than  this,  and  treated  the  stricture  of  the 
esophagus  itself. 

The  first  step  in  this  treatment  is  that  a  canula 
of  silver  or  tin  should  be  inserted  through  the  mouth 
and  pushed  down  the  throat  till  its  head  meets  an 
obstruction,  always  being  withdrawn  when  there  is 
a  vomiting  movement,  until  it  becomes  engaged  in 
the  stricture.  Then  freshly  milked  milk,  or  gruel 
made  from  farina  or  barley,  should  be  poured 
through  it.  He  says  that  in  these  cases  the  patient 
might  be  put  in  a  warm  milk  or  gruel  bath,  since 
there  are  some  physicians  who  believe  that  through 
the  lower  parts  of  the  body,  and  also  through  the 
pores  of  the  whole  body,  nutrition  might  be  taken 
up.    While  he   considers   that   this   latter  method 


132  OLD-TIME  MAKERS  OF  MEDICINE 

should  be  tried  in  suitable  cases,  he  has  not  very 
much  faith  in  it,  and  says  that  the  reasons  urged 
for  it  are  weak  and  rather  frivolous.  It  is  easy 
to  understand  that  a  man  who  has  reached  the  place 
in  medicine  where  he  can  recommend  manipulative 
treatments  of  this  kind,  and  discuss  nutritional 
modes  so  rationally,  knew  his  practical  medicine 
well,  and  wrote  of  it  judiciously. 

AVERROES 

Among  the  distinguished  contributors  to  medi- 
cine at  this  time,  though  more  a  philosopher  than  a 
physician,  is  the  famous  Averroes,  whose  full  Arabic 
name  among  his  contemporaries  was  Abul-Welid 
Mohammed  Ben  Ahmed  Ibn  Roschd  el-Maliki.  Like 
Avenzoar,  of  whom  he  was  the  intimate  persona] 
friend,  and  Abulcasis  and  Maimonides,  he  was  born 
in  the  south  of  Spain.  He  was  in  high  favor  with 
the  King  of  Morocco  and  of  Spain,  El-Mansur  Jacub, 
often  known  as  Almansor,  who  made  him  one  of  his 
counsellors.  His  works  are  much  more  important 
for  philosophy  than  for  medicine,  and  his  philo- 
sophical writings  gave  him  a  place  only  second  to 
that  of  Aristotle  in  the  Western  world  during  the 
Middle  Ages.  Averroism  is  still  a  subject  of  at  least 
academic  interest,  and  Renan's  monograph  on  it 
and  its  author  was  one  of  the  popular  books  of  the 
latter  half  of  the  nineteenth  century  in  philosophic 
circles.  In  spite  of  his  friendship  with  the  Moorish 
King  and  with  Avenzoar,  he  fell  under  the  suspi- 
cion of  free  thinking  and  was  brought  to  trial  with 
a  number  of  personal  friends,  who  occupied  high 


GREAT  ARABIAN  PHYSICIANS  133 

positions  in  the  Moorish  government.  He  escaped 
with  his  life,  but  only  after  great  risks,  and  he  was 
banished  to  a  suburb  of  Cordova,  in  which  only  Jews 
were  allowed  to  live.  By  personal  influence  he  suc- 
ceeded in  securing  the  pardon  of  himself  and 
friends,  and  then  was  summoned  to  the  court  of  the 
son  and  successor  of  El-Mansur  in  Morocco.  He 
died,  not  long  after,  in  1198. 

Altogether  there  are  some  thirty-three  works  of 
Averroes  on  philosophy  and  science.  Only  three 
of  these  are  concerned  with  medicine.  One  is  the 
"  Colliget,"  so-called,  containing  seven  books,  on 
anatomy,  physiology,  pathology,  diagnostics,  ma- 
teria medica,  hygiene,  and  therapy.  Then  there  is 
a  commentary  on  the  '  \  Cantica  of  Avicenna, ' '  and  a 
tractate  on  the  ' '  Theriac. ' '  Averroes y  idea  in  writ- 
ing about  medicine  was  to  apply  his  particular  sys- 
tem of  philosophy  to  medical  science.  His  intimate 
relations  with  other  great  physicians  of  the  time, 
and  in  particular  his  close  friendship  with  Avenzoar, 
enabled  him  to  get  abundant  medical  information  in 
faultless  order  so  far  as  knowledge  then  went,  but 
his  theoretic  speculations,  instead  of  helping  medi- 
cine, as  he  thought  they  would,  and  as  philosophers 
have  always  been  inclined  to  think  as  regards  their 
theoretic  contributions,  were  not  only  not  of  value, 
but  to  some  extent  at  least  hindered  human  progress 
by  diverting  men  from  the  field  of  observation  to 
that  of  speculation.  It  is  interesting  to  realize  that 
Averroes  did  in  his  time  what  Descartes  did  many 
centuries  later,  and  many  another  brilliant  thinker 
has  done  before  and  since. 


134  OLD-TIME  MAKERS  OF  MEDICINE 


ARABIAN  INFLUENCE 

The  fame  of  these  great  thinkers  and  writers  in 
philosophy  and  in  medicine  came  to  be  known  not 
only  through  the  distribution  of  their  books  long 
after  their  death,  but  during  their  lifetime,  and  in 
immediately  subsequent  generations,  ardent  seekers 
after  knowledge,  who  were  themselves  afterwards 
to  become  famous  by  their  teaching  and  writing, 
found  their  way  into  the  Arabian  dominions  in 
order  to  take  advantage  of  the  educational  oppor- 
tunities afforded.  These  were  better  than  they 
could  secure  at  home  in  Christian  countries,  be- 
cause the  process  of  bringing  culture  and  devotion 
to  literature  and  science  into  the  minds  of  the  North- 
ern nations,  who  had  replaced  the  old  Romans  in 
Europe,  was  not  yet  completed.  Bagdad  and  Cor- 
dova were  the  two  favorite  places  of  educational 
pilgrimage.  The  names  that  are  most  familiar 
among  the  scholars  in  the  Middle  Ages  in  Europe 
are  those  of  whom  it  is  recorded  that  they  made 
long  journeys  in  order  to  get  in  touch  with  what 
the  Arabs  had  preserved  of  the  old  Greek  civiliza- 
tion and  culture.  Among  them  are  such  men  as 
Michael  Scot  or  Scotus,  Matthew  Platearius,  who 
was  afterwards  a  great  teacher  at  Salerno;  Daniel 
Morley,  Adelard  of  Bath,  Egidius,  otherwise  known 
as  Grilles  de  Corbeil;  Romoaldus,  Gerbert  of 
Auvergne,  who  later  became  Pope  under  the  name 
of  Sylvester  II;  Gerard  of  Cremona,  and  the  best 
known  of  them  all,  at  least  in  medicine,  Constantine 
Africanus,  whose  wanderings,  however,  were  prob- 


GREAT  ARABIAN  PHYSICIANS  135 

ably  not  limited  to  Arabian  lands,  but  who  seems 
also  to  have  been  in  Hindustan. 

We  are  rather  prone  to  think  that  this  great  spirit 
of  going  far  afield  for  knowledge's  sake  is  recent, 
or,  at  least,  quite  modern.  As  a  matter  of  fact, 
one  finds  it  everywhere  in  history.  Long  before 
Herodotus  did  his  wanderings  there  were  many  vis- 
itors who  went  to  Egypt,  and  many  more  later  who 
went  to  Crete,  and  many  more  a  few  centuries  later 
who  went  to  the  shores  of  Asia  Minor  seeking  for 
the  precious  pearl  of  knowledge,  and  sometimes  find- 
ing it  without  finding  the  even  more  precious  pearl 
of  wisdom,  "  whose  worth  is  from  the  farthest 
coasts.' ' 

To  the  Arabs  we  owe  the  foundation  of  a  series 
of  institutions  for  the  higher  learning,  like  those 
which  had  existed  around  them  in  Asia  Minor  and 
in  Egypt  at  the  time  they  made  their  conquests. 
Alexandria,  Pergamos,  Cos,  Cnidos,  Tarsus,  and 
many  other  Eastern  cities  had  had  what  we  would 
call  at  least  academies,  and  many  of  them  deserved 
the  name  of  universities.  The  Arabs  continued  the 
tradition  in  education  that  they  found,  and  estab- 
lished educational  institutions  which  attracted  wide 
attention.  As  we  have  said,  the  two  most  famous 
of  these  were  at  Bagdad  and  at  Cordova.  Mostan- 
ser,  the  predecessor  of  the  last  Caliph  of  the  family 
of  the  Abbassides,  built  a  handsome  palace,  in  which 
the  academy  of  Bagdad  was  housed.  It  is  still  in 
existence,  and  gives  an  excellent  idea  of  the  benefi- 
cent interest  of  this  monarch  and  of  other  of  the 
Abbasside  rulers  in  education.  Its  fate  at  the  pres- 
ent time  is  typical  of  the  attitude  of  the  Moham- 


136  OLD-TIME  MAKEHS  OF  MEDICINE 

medans  towards  education.  Though  the  building  is 
still  standing,  the  institution  of  learning  is  no  longer 
there.  As  Hyrtl  remarks,  it  is  not  ideas  that  are 
exchanged  in  it  now,  but  articles  of  commerce.  It 
has  become  the  chief  office  of  the  Turkish  customs 
department  in  Bagdad. 

These  institutions  of  the  higher  learning,  founded 
by  the  Arabs,  at  first  as  rather  strict  imitations  of 
the  museums  or  academies  of  Egypt  and  Asia 
Minor,  gradually  changed  their  character  under  the 
Arabs.  Their  courses  became  much  more  formal, 
examinations  became  much  more  important.  Schol- 
arship was  sought  not  so  much  for  its  own  sake,  as 
because  it  led  to  positions  in  the  civil  service,  to  the 
favor  of  princes,  and,  in  general,  to  reputation  and 
pecuniary  reward.  Formal  testimonials  proclaim- 
ing education,  signed  by  the  academic  authorities, 
were  introduced  and  came  to  mean  much.  Lawyers 
could  not  practise  without  a  license,  physicians  also 
required  a  license.  These  formalities  were  adopted 
by  the  Western  medieval  universities  to  a  consid- 
erable degree  and  have  been  perpetuated  in  the  mod- 
ern time.  Undoubtedly  they  did  much  to  hamper 
real  education  among  the  Arabs  by  setting  in  place 
of  the  satisfaction  of  learning  for  its  own  sake 
and  the  commendation  of  teachers  the  formal  recog- 
nition of  a  certain  amount  of  work  done  as  recog- 
nized by  the  educational  authorities.  There  was  al- 
ways a  tendency  among  the  Arabs  to  formulate  and 
formalize,  to  over-systematize  what  they  were  at; 
to  think  that  new  knowledge  could  be  obtained 
simply  by  speculating  over  what  was  already  ac- 
quired, and  developing  it.    There  are  a  number  of 


GREAT  ARABIAN  PHYSICIANS  137 

comparisons  between  this  and  later  periods  of  edu- 
cation that  might  be  suggested  if  comparisons  were 
not  odious. 

The  influence  of  Arabian  medicine  on  modern 
medicine  can,  perhaps,  best  be  judged  from  the  num- 
ber of  words  in  our  modern  nomenclature,  which, 
though  bearing  Latin  forms,  often  with  suggestion 
of  Greek  origins,  still  are  not  derived  from  the  old 
Latin  or  Greek  authors,  but  represent  Arabic  terms 
translated  into  Latin  during  the  Eenaissance  period. 
Hyrtl,  without  pretence  of  quoting  them  all,  gives 
a  list  of  these  which  is  surprising  in  its  compre- 
hensiveness. For  instance,  the  mediastinum,  the 
sutura  sagittalis,  the  scrobiculus  cordis,  the  mar- 
supium  cordis,  the  chambers  of  the  heart,  the  velum 
palati,  the  trochanter,  the  rima  glottidis,  the  fon- 
tanels s,  the  alae  of  the  nose,  all  have  their  present 
names,  not  from  original  Latin  expressions,  but 
from  the  translation  of  Arabic  terms.  For  all  such 
words  the  Greeks  and  Eomans  have  quite  other  ex- 
pressions, in  which  the  sense  of  our  modern  terms 
is  not  contained.  This  has  given  rise  to  many  mis- 
understandings, and  to  many  attempts  in  the  mod- 
ern times  to  return  to  the  classic  terminology  rather 
than  preserve  what  in  many  cases  are  the  barba- 
risms introduced  through  the  Arabic,  but  it  is  doubt- 
ful whether  any  comprehensive  reform  in  the  matter 
can  be  effected,  so  strongly  entrenched  in  medical 
usage  have  these  terms  now  become. 

Freind,  in  his  "  History  of  Medicine,' '  already 
cited,  calls  attention  to  the  fact  that  the  Arabs  had 
an  unfortunate  tendency  to  change  by  addition  or 
subtraction  of  their  own  views  the  authors  that  they 


138  OLD-TIME  MAKERS  OF  MEDICINE 

studied,  and  wished  to  translate  to  others.  This 
seems  to  have  been  true  even  of  some  of  the  most 
distinguished  of  them.  Of  course,  the  idea  of  pre- 
serving an  author's  text  untouched,  and  making  it 
clear  just  where  note  and  commentary  came  in, 
had  not  yet  come  to  men's  view,  but  quite  apart  from 
this  the  Arabs  apparently  often  tried  to  gain  ac- 
ceptance for  their  own  ideas  by  having  them 
masquerade  as  the  supposed  ideas  of  favorite  classic 
authors. 

Another  unfortunate  tendency  among  the  Arabs 
was  their  liking  for  the  discussion  of  many  trivial 
questions.  Hyrtl,  in  his  volume  on  "  Arabian  and 
Hebrew  Words  in  Anatomy,"1  declares  that  it  is 
almost  incredible  how  earnestly  some  trivial  ques- 
tions in  anatomy  and  physiology  were  discussed  by 
the  Arabs.  He  gives  some  examples.  Why  does 
no  hair  grow  on  the  nose  of  men?  Why  does  the 
stomach  not  lie  behind  the  mouth?  Why  does  the 
windpipe  not  lie  behind  the  esophagus?  Why  are 
the  breasts  not  on  the  abdomen?  Why  are  not  the 
calves  on  the  anterior  portion  of  the  legs?  Even 
such  men  as  Rhazes  and  Avicenna  discuss  such 
questions. 

It  was  this  tendency  of  the  Arabs  that  passed 
over  to  the  Western  Europeans  with  Arabian  com- 
mentaries on  philosophy  and  science,  and  brought 
so  many  similar  discussions  in  the  scholastic  period. 
These  trivialities  have  usually  been  supposed  to 
originate  with  the  scholastics  themselves,  for  they 
are  not  to  be  found  in  the  Greek  authors  on  whom 

J"Das  Arabische  und  Hebraische  in  der  Anatomie,"  Dr.  Joseph 
Hyrtl,  Wien,  1879. 


GREAT  ARABIAN  PHYSICIANS  139 

the  scholastics  were  writing  commentaries,  but  they 
are  typically  Oriental  in  character,  and  it  must  be 
remembered  that  during  the  twelfth  and  early  thir- 
teenth centuries,  at  least,  Greek  philosophy  found 
its  way  largely  into  Europe  in  Arab  versions,  and 
these  characteristically  Arabian  additions  of  the 
discussion  of  curious  trivial  questions  came  with 
them  and  produced  an  imitative  tendency  among  the 
Europeans. 

As  a  rule  the  more  careful  has  been  the  study  of 
Arabian  writers  in  the  modern  time,  particularly 
by  specialists,  the  clearer  has  it  become  that  they 
lacked  nearly  all  originality.  Especially  were  they 
faulty  in  their  observations;  besides,  they  had  a 
definite  tendency  to  replace  observation  by  theory,  a 
fatal  defect  in  medicine.  The  fine  development  of 
surgery  that  came  at  the  end  of  the  Arabian  period 
of  medicine  in  Europe  could  never  have  come  from 
the  Arabs  themselves.  Gurlt  has  brought  this  out 
particularly,  but  it  will  not  be  difficult  to  cite  many 
other  good  authorities  in  support  of  this  opinion. 

Hyrtl,  in  his  "  Thesis  on  the  Earer  Old  Anato- 
mists,"1 says  that  "  the  Arabs  paid  very  little  at- 
tention to  anatomy,  and,  of  course,  because  of  the 
prohibition  in  the  Koran,  added  nothing  to  it.  What- 
ever they  knew  they  took  from  the  Greeks,  and  espe- 
cially Galen.  Not  only  did  they  not  add  anything 
new  to  this,  but  they  even  lost  sight  of  much  that 
was  important  in  the  older  authors.  The  Arabs 
were  much  more  interested  in  physiology;  they 
could  study  this  by  giving  thought  to  it  without  soil- 

l"  Anat.  Antiq.  Rariores,"  Vienna,  1835. 


140  OLD-TIME  MAKERS  OF  MEDICINE 

ing  their  hands.     They  delighted  in  theory,  rather 
than  in  observation. ' ' 

While  we  thus  discuss  the  lack  of  originality  and 
the  tendency  to  over-refinement  among  the  Arabian 
medical  writers,  it  must  not  be  thought  that  we 
would  make  little  of  what  they  accomplished.  They 
not  only  preserved  the  old  medical  writers  for  us, 
but  they  kept  alive  practical  medicine  with  the  prin- 
ciples of  the  great  Greek  thinkers  as  its  basis. 
There  are  a  large  number  of  writers  of  Arabian 
medicine  whose  names  have  secured  deservedly  a 
high  place  in  medical  history.  If  this  were  a  formal 
history  of  Arabian  medicine,  their  careers  and  works 
would  require  discussion.  For  our  purpose,  how- 
ever, it  seems  better  to  confine  attention  to  a  few 
of  the  most  prominent  Arabian  writers  on  medi- 
cine, because  they  will  serve  to  illustrate  how  thor- 
oughly practical  were  the  Arabian  physicians  and 
how  many  medical  problems  that  we  are  prone  to 
think  of  as  modern  they  occupied  themselves  with, 
solving  them  not  infrequently  nearly  as  we  do  in 
the  modern  time. 


VI 

THE  MEDICAL  SCHOOL  AT  SALERNO 

The  Medical  School  at  Salerno,  probably  organized 
early  in  the  tenth  century,  often  spoken  of  as  the 
darkest  of  the  centuries,  and  reaching  its  highest 
point  of  influence  at  the  end  of  the  twelfth  century, 
is  of  great  interest  in  modern  times  for  a  number  of 
reasons.  First  it  brought  about  in  the  course  of  its 
development  an  organization  of  medical  education, 
and  an  establishment  of  standards  that  were  to  be 
maintained  whenever  and  wherever  there  was  a  true 
professional  spirit  down  to  our  own  time.  They  in- 
sisted on  a  preliminary  education  of  three  years  of 
college  work,  on  at  least  four  years  of  medical  train- 
ing, on  special  study  for  specialist's  work,  as  in 
surgery,  and  on  practical  training  with  a  physician 
or  in  a  hospital  before  the  student  was  allowed  to 
practise  for  himself.  At  Salerno,  too,  the  depart- 
ment of  women's  diseases  was  given  over  to  women 
professors,  and  we  have  the  text-books  of  some  of 
these  women  medical  teachers.  The  license  to  prac- 
tise given  to  women,  however,  seems  to  have  been 
general  and  did  not  confine  them  merely  to  the  care 
of  women  and  children.  We  have  records  of  a  num- 
ber of  these  licenses  issued  to  women  in  the  neigh- 
borhood of  Salerno.  This  subject  of  feminine  med- 
ical education  at  Salerno,  because  of  its  special  inter- 
est in  our  time,  will  have  a  chapter  by  itself. 

141 


142  OLD-TIME  MAKERS  OF  MEDICINE 

These  are  the  special  features  of  medical  education 
in  our  own  time  that  we  are  rather  prone  to  think 
of  as  originating  with  ourselves  and  as  being  indices 
of  that  evolution  of  humanity  and  progress  in  man- 
kind which  are  culminating  in  our  era.  It  is  rather 
interesting,  then,  to  study  just  how  these  develop- 
ments came  about  and  what  the  genesis  of  this  great 
school  was.  The  books  of  its  professors  were  widely 
read,  not  only  in  their  own  generation  but  for  cen- 
turies afterwards.  With  the  invention  of  printing 
at  the  time  of  the  Eenaissance  most  of  them  were 
printed  and  exerted  profound  influence  over  the  re- 
vival of  medicine  which  took  place  at  that  time. 
Salerno  became  the  first  of  the  universities  in  the 
modern  sense  of  the  word.  Here  there  gathered 
round  the  medical  school,  first  a  preparatory  depart- 
ment representing  modern  college  work,  and  then 
departments  of  theology  and  law,  though  this  latter 
department  particularly  was  never  quite  successful. 
The  fact  that  the  first  university,  that  of  Salerno, 
should  have  been  organized  round  a  medical  school, 
the  second,  that  of  Bologna,  around  a  law  school,  and 
the  third,  that  of  Paris,  around  a  school  of  theology 
and  philosophy,  would  seem  to  represent  the  ordi- 
nary natural  process  of  development  in  human  inter- 
ests. First  man  is  interested  in  himself  and  in  his 
health,  then  in  his  property,  and  finally  in  his  rela- 
tions to  his  fellow-man  and  to  God. 

Though  much  work  has  been  done  on  the  subject 
in  recent  years,  it  is  not  easy  to  trace  the  origin  of 
the  medical  school  at  Salerno.  The  difficulty  is  em- 
phasized by  the  fact  that  even  the  earliest  chron- 
iclers whose  accounts  we  have  were  not  sure  as  to  its 


THE  MEDICAL  SCHOOL  AT  SALERNO  143 

origin,  and  even  had  some  doubt  about  the  age  of  the 
school.  Alphanus,  usually  designated  Alphanus  I  be- 
cause there  are  several  of  the  name,  who  is  one  of 
the  earliest  professors  whose  name  and  fame  have 
come  down  to  us,  gives  us  the  only  definite  detail  as 
to  the  age  of  the  school.  He  was  a  Benedictine 
monk,  distinguished  as  a  literary  man,  known  both 
as  poet  and  physician,  who  was  afterwards  raised  to 
the  Bishopric  of  Salerno.  As  a  bishop  he  was  one 
of  the  beneficent  patrons,  to  whom  the  school  owed 
much.  He  lived  in  the  tenth  century,  and  states  that 
medicine  flourished  in  the  town  before  the  time  of 
Guimarus  II,  who  reigned  in  the  ninth  century.  In 
the  ancient  chronicle  of  Salerno,  re-discovered  by  De 
Eenzi  and  published  in  his  6 '  Collectio  Salernitana, ' • 
it  is  definitely  recorded  that  the  medical  school  was 
founded  by  four  doctors, — a  Jewish  Eabbi  Elinus, 
a  Greek  Pontus,  a  Saracen  Adala,  an  Arab,  and  a 
native  of  Salerno,  each  of  whom  lectured  in  his 
native  language.  There  are  many  elements  in  this 
tradition,  however,  that  would  seem  to  indicate  its 
mythical  origin  and  that  it  was  probably  invented 
after  the  event  to  account  for  the  presence  of  teach- 
ers in  all  these  languages  and  the  coming  of  students 
from  all  over  the  world.  The  names,  for  instance, 
are  apparently  corruptions  of  real  names,  as  can  be 
readily  recognized.  Elinus,  the  Jew,  is  probably 
Elias  or  Eliseus,  Adala  is  a  corruption  of  Abdallah, 
and  Pontus,  as  pointed  out  by  Puschmann  in  his 
"  History  of  Medical  Education,' '  should  probably 
be  Gario-Pontus. 

While  we  do  not  know  exactly  when  the  medical 
school  at  Salerno  was  founded,  we  know  that  a  hos- 


144  OLD-TIME  MAKERS  OF  MEDICINE 

pital  was  established  there  as  early  as  820.  It  was 
founded  by  the  Archdeacon  Adelmus,  and  was 
placed  under  the  control  of  the  Benedictines  after  it 
was  realized  that  a  religious  order,  by  its  organiza- 
tion, was  best  fitted  for  carrying  on  such  charitable 
work  continuously.  Other  infirmaries  and  charitable 
institutions,  mainly  under  control  of  the  religious, 
sprang  up  in  Salerno.  It  was  the  presence  of  these 
hospitals  in  a  salubrious  climate  that  seems  first  to 
have  attracted  the  attention  of  patients  and  then  of 
physicians  from  all  over  Europe  and  even  adjacent 
Africa  and  Asia.  Puschmann  says  that  it  is  uncer- 
tain whether  clinical  instruction  was  imparted  in 
these  institutions  or  not,  but  the  whole  tenor  of  what 
we  know  about  the  practical  character  of  the  teach- 
ing at  Salerno  and  of  the  fine  development  of  profes- 
sional medicine  there,  would  seem  to  argue  that 
probably  those  who  came  to  study  medicine  here 
were  brought  directly  in  contact  with  patients. 

As  early  as  the  ninth  century  Salerno  was  famous 
for  its  great  physicians.  We  know  the  names  of  at 
least  two  physicians,  Joseph  and  Joshua,  who  prac- 
tised there  about  the  middle  of  the  ninth  century. 
Eagenifrid,  a  Lombard  by  his  name,  was  private 
physician  to  Prince  Wyamar  of  Salerno  in  the  year 
900.  The  fact  that  he  was  from  North  Italy  indi- 
cates that  already  foreigners  were  being  attracted, 
but  more  than  this  that  they  were  obtaining  oppor- 
tunities unhampered  by  any  Chauvinism.  From 
early  in  the  tenth  century  physicians  from  Salerno 
were  frequently  brought  to  foreign  courts  to  become 
the  attending  physicians  to  rulers.  Patients  of  the 
highest  distinction  from  all  over  Europe  began  to 


THE  MEDICAL  SCHOOL  AT  SALEBNO  145 

flock  to  Salerno,  and  we  have  the  names  of  many  of 
them.  In  the  tenth  century  Bishop  Adalberon, 
when  ailing,  went  there,  though  he  found  no  cure 
for  his  ills.  Abbot  Desiderius,  however,  the  great 
Benedictine  scholar  of  the  time,  who  afterwards  be- 
came Pope  Victor  III,  regained  his  health  at  Sa- 
lerno under  the  care  of  the  great  Constantine  Afri- 
canus,  who  was  so  much  impressed  by  the  gentle 
kindness  and  deep  learning  and  the  example  of  the 
saintly  life  of  his  patient  that  not  long  after  he  went 
to  Monte  Cassino  to  become  a  Benedictine  under 
Desiderius,  who  was  abbot  there.  Duke  Guiscard 
sent  his  son  Bohemund  to  Salerno  for  the  cure  of 
a  wound  received  in  battle,  which  had  refused  to 
heal  under  the  ordinary  surgical  treatment  of  the 
time.  William  the  Conqueror,  early  in  the  eleventh 
century  and  while  still  only  the  Duke  of  Normandy, 
is  said  to  have  passed  some  time  at  Salerno  for  a 
similar  reason. 

The  most  interesting  feature  of  the  medical  life  at 
Salerno  at  this  time  is  the  relations  between  the 
clergy  and  the  physicians.  In  the  sketch  of  the  life 
of  Constantine  Africanus,  which  follows  this  chap- 
ter, there  is  some  account  of  the  friendship  between 
Abbot  Desiderius  of  Monte  Cassino  and  Constantine 
Africanus,  and  the  latter 's  withdrawal  from  his  pro- 
fessorship to  become  a  Benedictine.  One  of  the  phy- 
sicians of  the  early  tenth  century  who  stood  high  in 
favor  with  Prince  Gisulf  was  raised  to  the  Bishopric 
of -Salerno.  This  was  Alphanus,  whom  we  have  al- 
ready mentioned  as  a  chronicler,  a  monk,  a  poet,  a 
physician,  and  finally  the  Bishop  of  Salerno. 

The  best  proof  of  how  thorough  was  the  medical 


146  OLD-TIME  MAKEES  OF  MEDICINE 

education  at  Salerno  and  how  much  influence  it  ex- 
erted even  over  public  opinion  is  to  be  found  in  the 
regulation  of  the  practice  of  medicine,  which  soon 
began,  and  the  insistence  upon  proper  training  be- 
fore permission  to  practise  medicine  was  granted. 
The  medical  school  at  Salerno  early  came  to  be  a 
recognized  institution  in  the  kingdom  of  the  Two 
Sicilies,  representing  a  definite  standard  of  medical 
training.  It  is  easy  to  understand  that  the  attrac- 
tion which  Salerno  possessed  for  patients  soon  also 
brought  to  the  neighborhood  a  number  of  irregular 
physicians,  travelling  quacks,  and  charlatans. 
Wealthy  patients  were  coming  from  all  over  the 
world  to  be  treated  at  Salerno.  Many  of  them  doubt- 
less were  sufferers  from  incurable  diseases  and  noth- 
ing could  be  done  for  them.  Often  they  would  be 
quite  unable  to  return  to  their  homes  and  would  be 
surely  unwilling  to  give  up  all  hope  if  anybody  prom- 
ised them  anything  of  relief.  There  was  a  rich  field 
for  the  irregular,  and  of  course,  as  always,  he  came. 
Salerno  had  already  shown  what  a  good  standard  of 
medical  education  should  be,  and  it  is  not  surprising, 
then,  that  the  legal  authorities  in  this  part  of  the 
country  proceeded  to  the  enforcement  of  legal  regu- 
lations demanding  the  attainment  of  this  standard, 
in  order  that  unfit  and  unworthy  physicians  might 
not  practise  medicine  to  their  own  benefit  but  to  the 
detriment  of  the  patients. 

Accordingly,  as  early  as  the  year  1140,  King  Rug- 
giero  (Roger)  of  the  Two  Sicilies  promulgated  the 
law : ' '  Whoever  from  this  time  forth  desires  to  prac- 
tise medicine  must  present  himself  before  our  of- 
ficials and  judges,  and  be  subject  to  their  decision. 


THE  MEDICAL  SCHOOL  AT  SALERNO  147 

Anyone  audacious  enough  to  neglect  this  shall  be 
punished  by  imprisonment  and  confiscation  of  goods. 
This  decree  has  for  its  object  the  protection  of  the 
subjects  of  our  kingdom  from  the  dangers  arising 
from  the  ignorance  of  practitioners." 

Just  about  a  century  later  the  Emperor  Frederick 
II,  the  Hohenstaufen,  in  the  year  1240,  extended  this 
law,  emphasized  it,  and  brought  it  particularly  into 
connection  with  the  great  medical  school  of  the  Two 
Sicilies,  of  which  territory  he  was  the  ruler.  This 
law  has  often  been  proclaimed  as  due  to  his  person- 
ality rather  than  to  his  times, — as  representing  his 
very  modern  spirit  and  his  progressive  way  of  look- 
ing at  things.  There  is  no  doubt  that  certain  per- 
sonal elements  for  which  he  should  be  given  due 
credit  are  contained  in  the  law.  To  understand  it 
properly,  however,  one  must  know  the  law  of  King 
Eoger  of  the  preceding  century;  and  then  it  is  easy 
to  appreciate  that  Frederick's  regulation  is  only 
such  a  development  of  the  governmental  attitude  to- 
ward medical  practice  as  might  have  been  expected 
during  the  century  since  Roger's  time.  It  has  some- 
times been  suggested  that  this  law  made  by  the  Em- 
peror Frederick,  who  was  so  constantly  in  bitter 
opposition  to  the  Papacy,  was  issued  in  despite  of  the 
Church  authorities  and  represents  a  policy  very  dif- 
ferent from  any  which  they  would  have  encouraged. 
The  early  history  of  Salerno,  even  briefly  as  we 
have  given  it,  completely  contradicts  any  such  idea. 
The  history  of  medical  regulation  at  the  beginning  of 
the  next  century  down  at  Montpellier  moreover, 
where  the  civil  authorities  being  weak  the  legal  or- 
dering of  the  practice  of  medicine  was  effectively 


143  OLD-TIME  MAKERS  OF  MEDICINE 

taken  up  by  the  Church,  and  the  authority  for  the 
issuance  of  licenses  to  practise  was  in  the  hands  of 
the  bishops  of  the  neighborhood,  shows  clearly  that 
it  is  not  because  of  any  knowledge  of  the  real  medical 
history  of  the  times  that  such  remarks  are  made,  but 
from  a  set  purpose  to  discredit  the  Church. 

The  Emperor  Frederick's  law  deserves  profound 
respect  and  consideration  because  of  the  place  that 
it  holds  in  the  legal  regulation  of  the  practice  of 
medicine.  Anyone  who  thinks  that  evolution  must 
have  brought  us  in  seven  centuries  much  farther  in 
this  matter  than  were  the  people  of  the  later  Middle 
Ages  should  read  this  law  attentively.  Everyone 
who  is  interested  in  medical  education  should  have 
a  copy  of  it  near  him,  because  it  will  have  a  chasten- 
ing effect  in  demonstrating  not  only  how  little  we 
have  done  in  the  modern  time  rather  than  how  much, 
but  above  all  how  much  of  decadence  there  was  dur- 
ing many  periods  of  the  interval.  The  law  may 
be  found  in  the  original  in  "  The  Popes  and 
Science  ,?  (Fordham  University  Press,  N.  Y.,  1908). 
Three  years  of  preliminary  university  education  be- 
fore the  study  of  medicine  might  be  taken  up,  four 
years  of  medical  studies  proper  before  a  degree  was 
given,  a  year  of  practice  with  a  regularly  licensed 
physician  before  a  license  to  practise  could  be  ob- 
tained, a  special  course  in  anatomy  if  surgery  were 
to  be  practised ;  all  this  represents  an  ideal  we  are 
^striving  after  at  the  present  time  in  medical  edu- 
cation. Besides  this,  Frederick's  law  also  regulates 
medical  fees,  requires  gratuitous  attendance  on  the 
poor  for  the  privilege  of  practice  accorded  by  the 
license,  though  the  general  fees  are  of  a  thoroughly 


THE  MEDICAL  SCHOOL  AT  SALERNO  149 

professional  character  and  represent  for  each  visit 
of  the  physician  about  the  amount  of  daily  wage  that 
\  the  ordinary  laborer  of  that  time  earned.  Curiously 
enough,  this  same  ratio  of  emolument  has  maintained 
itself.  This  law  was  also  a  pure  drug  law,  regulat- 
ing the  practice  of  pharmacy,  and  the  price  as  well 
as  the  purity  of  drugs,  and  the  relations  of  phy- 
sicians, druggists,  and  the  royal  drug  inspectors 
whose  business  it  was  to  see  that  only  proper  drugs 
were  prepared  and  sold. 

All  this  is  so  much  more  advanced  than  we  could 
possibly  have  imagined,  only  that  the  actual  docu- 
ments are  in  our  possession,  that  most  people  refuse 
to  let  themselves  be  persuaded  in  spite  of  the  law 
that  it  could  have  meant  very  much.  Especially  as 
regards  medical  education  are  they  dubious  as  to 
conditions  at  this  time.  To  them  it  seems  that  it 
can  make  very  little  difference  how  much  time  was 
required  for  medical  study  or  for  studies  prelim- 
inary to  medicine,  since  there  was  so  little  to  be 
learned.  The  age  was  ignorant,  men  knew  but  little, 
and  so  very  little  could  be  imparted  no  matter  how 
much  time  was  taken. 

This  is,  I  fear,  a  common  impression,  but  an  ut- 
terly false  one.  The  preliminary  training  that  is 
the  undergraduate  work  at  the  universities  consisted 
of  the  Seven  Liberal  Arts- — the  trivium  and  quad- 
rivium,  which  embraced  logic,  rhetoric,  grammar, 
metaphysics,  under  which  was  included  not  a  little 
of  physics,  cosmology  in  which  some  biology  was 
studied,  as  well  as  psychology  and  mathematics^  as- 
tronomy, and  music.  This  was  a  thoroughly 
rounded  course  in  intellectual  training.    No  wonder 


150  OLD-TIME  MAKERS  OF  MEDICINE 

that  Professor  Huxley  said  in  his  Inaugural  Ad- 
dress as  Eector  of  Aberdeen,  "  I  doubt  if  the  cur- 
riculum of  any  modern  university  shows  so  clear  and 
generous  a  comprehension  of  what  is  meant  by  cul- 
ture as  this  old  trivium  and  quadrivium  does." 
There  is  no  doubt  at  all  about  the  value  of  the  under- 
graduate training,  nor  of  the  scholarship  of  the  men 
who  were  turned  out  under  the  system,  nor  of  their 
ability  to  concentrate  their  minds  on  difficult  sub- 
jects— a  faculty  that  we  strive  to  cultivate  in  our 
time  and  do  not  always  congratulate  ourselves  on 
securing  to  the  degree,  at  least,  that  we  would  like. 

As  to  the  medical  teaching,  -ZEgidius,  often  called 
Gilles  of  Corbeil,  who  was  a  graduate  of  Salerno 
and  afterward  became  the  physician-in-ordinary  to 
Philip  Augustus,  King  of  France,  thought  that  he 
could  not  say  too  much  for  the  training  in  medicine 
that  was  given  at  this  first  of  the  medical  schools. 
One  thing  is  sure,  the  professors  were  eminently 
serious,  the  work  taken  up  was  in  many  ways  thor- 
oughly scientific,  and  some  of  the  results  of  the 
medical  investigations  of  that  early  day  are  inter- 
esting even  now.  The  descriptions  of  diseases  that 
we  have  from  the  Salernitan  school  are  true  to  na- 
ture and  are  replete  with  many  original  observa- 
tions. Puschmann  says :  * '  The  accounts  given  of 
intermittent  fever,  pneumonia,  phthisis,  psoriasis, 
lupus,  which  they  called  the  malum  mortuum,  of 
ulcers  on  the  sexual  organs,  among  which  it  is  easy 
to  recognize  chancre,  and  of  the  disturbances  of  the 
mental  faculties,  especially  deserve  mention. ' '  They 
seem  to  have  been  quite  expert  in  their  knowledge  of 
phthisis.    In  the  treatment  of  it  they  laid  great 


THE  MEDICAL  SCHOOL  AT  SALERNO  151 

stress  upon  the  giving  up  of  a  strenuous  life,  the 
living  a  rather  easy  existence  in  the  open  air,  and  a 
suitable  diet.  When  the  commencement  of  consump- 
tion was  suspected,  the  first  prescription  was  a  good 
course  of  strengthening  nourishment  for  the  pa- 
tient. On  the  other  hand,  they  declared  that  the 
cases  in  which  diarrhea  supervened  during  consump- 
tion soon  proved  fatal.  In  general,  with  regard  to 
people  who  were  liable  to  respiratory  diseases,  they 
insisted  upon  life  in  an  atmosphere  of  equable  tem- 
perature. Though  the  custom  was  almost  unheard 
of  in  the  Salerno  of  that  time,  and  indeed  at  the 
present  time  there  is  very  little  heating  during  the 
winter  in  southern  Italy,  they  insisted  that  patients 
who  were  liable  to  pulmonary  affections  should  have 
their  rooms  heated. 

On  the  other  hand,  they  suggested  the  cooling  of 
the  air  of  the  sick-room,  as  we  have  noted  in  the 
chapter  on  Constantine  Africanus,  and  Afflacius  rec- 
ommended the  employment  of  an  apparatus  from 
which  water  trickled  continuously  in  drops  to  the 
ground  and  then  evaporated.  Baths  and  bleeding 
were  employed  according  to  definite  indications  and 
diet  was  always  a  special  feature.  They  had  a  num- 
ber of  drugs  and  simples,  and  the  employment  of 
some  of  them  is  interesting.  Iron  was  prescribed 
for  enlargement  of  the  spleen.  The  internal  use  of 
sea  sponge,  in  which  of  course  there  is  a  noteworthy 
proportion  of  iodine,  was  recommended  for  relief 
from  the  symptoms  of  goitre  by  reducing  its  size. 
Iodine  has  been  used  so  much  ever  since  in  this  af- 
fection, even  down  to  our  own  day,  that  this  employ- 
ment of  one  of  its  compounds  is  rather  striking. 


152  OLD-TIME  MAKERS  OF  MEDICINE 

Massage  of  the  goitre  was  also  recommended,  and 
this  mode  of  treatment  was  commonly  employed  for 
a  number  of  ailments. 

Probably  the  best  idea  that  can  be  obtained  in 
brief  space  of  the  achievements  of  the  University 
of  Salerno  is  to  be  found  in  Pagel's  appreciation  of 
Salerno's  place  in  the  history  of  medicine  in  his 
chapters  on  "  Medicine  in  the  Middle  Ages  "  in 
Puschmann's  "  Handbuch  der  Geschichte  der  Me- 
dizin  ' '  (Berlin,  1902) .  He  said : ' '  If  we  take  up  now 
the  accomplishments  of  the  school  of  Salerno  in  the 
different  departments  there  is  one  thing  that  is  very 
remarkable.  It  is  the  rich  independent  productivity 
with  which  Salerno  advanced  the  banners  of  medical 
science  for  hundreds  of  years  almost  as  the  only  au- 
tochthonous centre  of  medical  influence  in  the  whole 
West.  One  might  almost  say  that  it  was  like  a 
versprengten  Keim — a  displaced  embryonic  ele- 
ment— which,  as  it  unfolded,  rescued  from  destruc- 
tion the  ruined  remains  of  Greek  and  Eoman  medi- 
cine. This  productivity  of  Salerno,  which  may  well 
be  compared  in  quality  and  quantity  with  that  of 
the  best  periods  of  our  science,  and  in  which  no  de- 
partment of  medicine  was  left  without  some  ad- 
vance, is  one  of  the  striking  phenomena  of  the  history 
of  medicine.  While  positive  progress  was  not  made, 
there  are  many  noteworthy  original  observations  to 
be  chronicled.  It  must  be  acknowledged  that  pupils 
and  scholars  set  themselves  faithfully  to  their  tasks 
to  further  as  far  as  their  strength  allowed  the  sci- 
ence and  art  of  healing.  In  the  medical  writers  of 
the  older  period  of  Salerno  who  had  not  yet  been 
disturbed  by  Arabian  culture  or  scholasticism,  we 


THE  MEDICAL  SCHOOL  AT  SALERNO  153 

cannot  but  admire  the  clear,  charmingly  smooth, 
light-flowing  diction,  the  delicate  and  honest  setting 
forth  of  cases,  the  simplicity  of  their  method  of 
treatment,  which  was  to  a  great  extent  dietetic  and 
expectant,  and  while  we  admire  the  carefulness  and 
yet  the  copiousness  of  their  therapy,  we  cannot  but 
envy  them  a  certain  austerity  in  their  pharmaceutic 
formulas  and  an  avoidance  of  medicamental  poly- 
pragmasia.  The  work  in  internal  medicine  was  espe- 
cially developed.  The  contributions  to  it  from  a 
theoretic  and  a  literary  standpoint,  as  well  as  from 
practical  applications,  found  ardent  devotees.' ' 

Less  than  this  could  scarcely  have  been  expected 
from  the  medical  school  which  brought  such  an  up- 
lift of  professional  dignity  and  advance  in  the  stand- 
ards of  medical  education  that  are  to  be  noticed  in 
connection  with  Salerno.  Eegistration,  licensure, 
preliminary  education,  adequate  professional  studies, 
clinical  experience  under  expert  guidance,  even  spe- 
cial training  for  surgical  work,  all  came  in  connec- 
tion with  this  great  medical  school.  Such  practical 
progress  in  medical  education  could  not  have  been 
made  but  by  men  who  faced  the  problems  of  the  prac- 
tice of  medicine  without  self-deception  and  solved 
them  as  far  as  possible  by  common-sense,  natural, 
and  rational  methods. 

It  is  usually  said  that  at  Salerno  surgery  occupied 
an  inferior  position.  It  is  true  that  we  have  less 
record  of  it  in  the  earlier  years  of  Salerno  than  we 
would  like  to  see.  It  was  somewhat  handicapped  by 
the  absence  of  human  dissection.  This  very  impor- 
tant defect  was  not  due  to  any  Church  opposition  to 
anatomy,  as  has  often  been  said,  but  to  the  objection 


a 
154  OLD-TIME  MAKERS  OF  MEDICINE 

that  people  have  to  seeing  the  bodies  of  their  friends 
or  acquaintances  used  for  anatomical  purposes.  In 
the  comparatively  small  towns  of  the  Middle  Ages 
there  were  few  strangers,  and  therefore  very  seldom 
were  there  unclaimed  bodies.  The  difficulty  was  in 
the  obtaining  of  dissecting  material.  We  had  the 
same  difficulty  in  this  country  until  about  two  gen- 
erations ago,  and  the  only  way  that  bodies  could  be 
obtained  regularly  was  by  "  resurrecting  "  them, 
as  it  was  called,  from  graveyards.  In  the  ab- 
sence of  human  subjects,  anatomy  was  taught  at 
Salerno  upon  the  pig.  The  principal  portion  of  the 
teaching  in  anatomy  consisted  of  the  demonstration 
of  the  organs  in  the  great  cavities  of  the  body  and 
their  relations,  with  some  investigations  of  their 
form  and  the  presumed  functions  of  the  correspond- 
ing organs  in  man.  Copho  's  well-known  ' i  Anatomy 
of  the  Pig  ' '  was  a  text-book  written  for  the  students 
of  Salerno.  In  spite  of  its  limitations,  it  shows  the 
beginnings  of  rather  searching  original  inquiry  and 
even  some  observations  in  pathological  anatomy.  It 
is  simple  and  straightforward  and  does  not  profess 
to  be  other  than  it  is,  though  it  must  be  set  down  as 
the  first  reasonably  complete  contribution  to  com- 
parative anatomy. 

When  their  surgery  came  to  be  written  down, 
however,  it  gave  abundant  evidence  of  the  thorough- 
ness with  which  this  department  of  medicine  had 
been  cultivated  by  the  Salernitan  faculty.  We  have 
the  text-book  of  Eoger,  with  the  commentary  of  Eo- 
lando,  and  then  the  so-called  commentary  of  the 
Four  Masters.  These  writings  were  probably  made 
rather  for  the  medical  school  at  Bologna  than  that 


THE  MEDICAL  SCHOOL  AT  SALERNO  155 

of  Salerno,  though  there  is  no  doubt  that  at  least 
Eoger  and  Rolando  received  their  education  at  Sa- 
lerno and  embodied  in  their  writings  the  surgical 
traditions  of  that  school.  While  I  have  preferred,  in 
order  to  have  a  connected  story  of  surgical  develop- 
ment, to  treat  of  their  contributions  to  their  specialty 
under  the  head  of  the  ' '  Great  Surgeons  of  the  Me- 
dieval Universities, ' '  it  seems  well  to  point  out  here 
that  they  must  be  considered  as  representing  espe- 
cially the  surgical  teaching  of  the  older  medical 
school  of  Salerno.  There  are  many  interesting  fea- 
tures of  the  old  teaching  that  they  have  embodied 
in  their  books.  For  instance,  at  Salerno  both  sutures 
and  ligatures  were  employed  in  order  to  prevent 
bleeding.  We  are  rather  accustomed  to  think  of  such 
uses  of  thread,  and  especially  the  ligature,  as  being 
much  later  inventions.  The  fact  of  the  matter  is, 
however,  that  ligatures  and  sutures  were  reinvented 
over  and  over  again  and  then  allowed  to  go  out  of 
use  until  someone  who  had  no  idea  of  their  dangers 
came  to  reinvent  them  once  more.1 

*It  seems  hard  to  understand  how  so  useful  an  auxiliary  to  the 
surgeon  as  the  ligature, — it  seems  indispensable  to  us, — could  pos- 
sibly be  allowed  to  go  out  of  use  and  even  be  forgotten.  It  will  not 
be  difficult,  however,  for  anyone  who  recalls  the  conditions  that 
obtained  in  old-time  surgery.  The  ligature  is  a  most  satisfying 
immediate  resource  in  stopping  bleeding  from  an  artery,  but  a  septic 
ligature  inevitably  causes  suppuration  and  almost  inevitably  leads 
to  secondary  hemorrhage.  In  the  old  days  of  septic  surgery  sec- 
ondary hemorrhage  was  the  surgeon's  greatest  and  most  dreaded 
bane.  Some  time  from  the  fifth  to  the  ninth  day  a  septic  ligature 
came  away  under  conditions  such  that  inflammatory  disturbance  had 
prevented  sealing  of  the  vessel.  If  the  vessel  was  large,  then  the 
hemorrhage  was  fast  and  furious  and  the  patient  died  in  a  few 
minutes.     After  a  surgeon  had  had  a  few  deaths  of  this  kind  he 


156  OLD-TIME  MAKERS  OF  MEDICINE 

Much  is  often  said  about  the  place  of  Arabian  sur- 
gery and  medicine  at  this  time,  and  the  influence 
that  they  had  over  the  medical  teaching  and  think- 
ing of  the  period.  To  trust  many  of  the  shorter 
histories  of  medicine  the  Arabs  must  be  given  credit 
for  more  of  the  medical  thought  of  this  time  than  any 
other  medical  writers  or  thinkers.  It  is  forgotten, 
however,  apparently,  that  in  the  southern  part  of 
Italy,  where  Salerno  was  situated,  Greek  influence 
never  died  out.  This  had  been  a  Greek  colony  in 
the  olden  time  and  continued  to  be  known  for  many 
centuries  after  the  Christian  era  as  Magna  Graecia. 
Greek  medicine,  then,  had  more  influence  here  than 
anywhere  else.  As  a  matter  of  fact,  the  beginnings 
of  Salernitan  teaching  are  all  Greek  and  not  at  all 
Arabian.  This  is  as  true  in  surgery  as  in  medicine. 
I  have  quoted  Gurlt  in  the  chapter  on  "  Great  Sur- 
geons of  the  Medieval  Universities, "  insisting  that 
the  Salernitan  school  owed  nothing  at  all  to  Arabian 
surgery.  Salernitan  medicine  was,  during  the 
twelfth  century,  just  as  free  from  Arabian  influence. 
When  Arabian  medicine  makes  itself  felt,  as  pointed 
out  by  Pagel  in  his  "  Geschichte  der  Heilkunde  im 
Mittelalter, ' ' x  far  from  exerting  a  beneficial  influ- 

dreaded  the  ligature.  He  abandoned  its  use  and  took  kindly  to  such 
methods  as  the  actual  cautery,  red-hot  knives  for  amputations,  and 
the  like,  that  would  sear  the  surfaces  of  tissues  and  the  blood- 
vessels, and  not  give  rise  to  secondary  hemorrhage.  A  little  later, 
however,  someone  not  familiar  with  secondary  risks  would  reinvent 
the  ligature.  If  he  were  cleanly  in  his  methods  and,  above  all,  if 
he  were  doing  his  work  in  a  new  hospital,  the  ligature  worked  very 
well  for  a  while.  If  not,  it  soon  fell  into  innocuous  desuetude  again, 
^uschmann:  "  Handbuch  der  Geschichte  der  Medizin,"  Vol.  I,  page 
652. 


THE  MEDICAL  SCHOOL  AT  SALERNO  157 

ence,  it  had  a  rather  unfortunate  effect.  It  led  espe- 
cially to  an  oversophistication  of  medicine  from  the 
standpoint  of  drug  therapeutics.  The  Arabian 
physicians  trusted  nature  very  little.  In  this  they 
were  like  our  forefathers  of  medicine  one  hundred 
years  ago,  of  whom  Rush  was  the  typical  representa- 
tive— so  history  repeats  itself. 

Before  the  introduction  of  Arabian  medicine  the 
Salernitan  school  of  medicine  was  noted  for  its 
common- sense  methods  and  its  devotion  to  all  the 
natural  modes  of  healing.  It  looked  quite  as  much 
to  the  prevention  of  disease  as  its  treatment.  Diet 
and  air  and  water  were  always  looked  upon  as  sig- 
nificant therapeutic  aids.  With  the  coming  of  Ara- 
bian influence  there  began,  says  Pagel,  "  as  the  lit- 
erature of  the  times  shows  very  well,  that  rule  of 
the  apothecary  in  therapeutics  which  was  an  unfor- 
tunate exaggeration.  Now  all  the  above-mentioned 
complicated  prescriptions  came  to  be  the  order  of 
the  day.  Apparently  the  more  complicated  a  pre- 
scription the  better.  Dietetics  especially  was  rele- 
gated to  the  background.  Salerno,  at  the  end  of  the 
twelfth  century,  had  already  reached  its  highest 
point  of  advance  in  medicine  and  was  beginning  to 
decline.  Decadence  was  evident  in  so  far  as  all  the 
medical  works  that  we  have  from  that  time  are  either 
borrowings  or  imitations  from  Arabian  medicine 
with  which  eventually  Salernitan  medical  literature 
became  confounded.  Only  a  few  independent  au- 
thors are  found  after  this  time."  This  is  so  very 
different  from  what  is  ordinarily  presumed  to  have 
been  the  case  and  openly  proclaimed  by  many  his- 
torians of  medicine  because  apparently  they  would 


158  OLD-TIME  MAKERS  OF  MEDICINE 

prefer  to  attribute  scientific  advance  to  the  Arabs 
than  to  the  Christian  scholars  of  the  time,  that  it  is 
worth  while  noting  it  particularly. 

Salerno  was  particularly  rich  in  its  medical  lit- 
erary products.  Very  often  we  have  not  the  names 
of  the  writers.  Apparently  there  is  good  reason  to 
think  that  a  number  of  the  professors  consulted  to- 
gether in  writing  a  book,  and  when  it  was  issued  it 
was  considered  to  be  a  text-book  of  the  Salernitan 
school  of  medicine  rather  than  of  any  particular  pro- 
fessor. This  represents  a  development  of  co-opera- 
tion on  the  part  of  colleagues  in  medical  teaching 
that  we  are  likely  to  think  of  as  reserved  for  much 
later  times. 

The  most  important  medical  writing  that  comes  to 
us  from  Salerno,  in  the  sense  at  least  of  the  work  that 
has  had  most  effect  on  succeeding  generations,  has 
been  most  frequently  transcribed,  most  often  trans- 
lated and  committed  to  memory  by  many  generations 
of  physicians,  is  the  celebrated  Salernitan  medical 
poem  on  hygiene.  The  title  of  the  original  Latin 
was  "  Eegimen  Sanitatis  Salernitanum. ' '  It  was 
probably  written  about  the  beginning  of  the  twelfth 
century.  A  century  or  so  later  it  came  to  be  the  cus- 
tom to  call  medical  books  after  flowers,  and  so  we 
had  the  "  Lilium  Medicine  "  and  the  "  Flos  Medi- 
cines "  down  at  Montpellier,  and  this  became  the 
"  Flos  Medicinae  "  of  Salerno.  Pagel  calls  it  the 
quintessence  of  Salernitan  therapeutics. 

For  many  centuries  portions  at  least  of  this  Latin 
medical  poem  were  as  common  in  the  mouths  of 
physicians  all  over  Europe  as  the  aphorisms  of  Hip- 
pocrates or  the  sayings  of  Galen.    Probably  this  en- 


THE  MEDICAL  SCHOOL  AT  SALERNO  159 

ables  us  to  understand  the  great  reputation  that  the 
Salernitan  school  enjoyed  and  the  influence  that  it 
wielded  better  than  anything  else.  The  poem  is  di- 
vided into  ten  principal  parts,  containing  altogether 
about  3,500  lines.  The  first  part  on  hygiene  has  855 
lines  in  eight  chapters.  The  second  part  on  materia 
medica,  though  containing  only  four  chapters,  has 
also  about  800  lines.  Anatomy  and  physiology 
are  crowded  into  about  200  lines,  etiology  has  some- 
thing over  200,  semiotics  has  about  250,  pathology 
has  but  thirty  lines  more  or  less,  and  therapeutics 
about  400 ;  nosology  has  about  600  more,  and  finally 
there  is  something  about  the  physician  himself,  and 
an  epilogue.  As  Latin  verses  go,  when  written  for 
such  purposes,  these  are  not  so  bad,  though  some 
of  them  would  grate  on  a  literary  ear.  The  whole 
work  makes  a  rather  interesting  compendium  of 
medicine,  with  therapeutic  indications  and  contra- 
indications, and  whatever  the  physician  of  the  me- 
dieval period  needed  to  have  ready  to  memory. 
Some  of  its  prescriptions,  both  in  the  sense  of 
formulae  and  of  directions  to  the  patient,  have  quite 
a  modern  air. 

One  very  interesting  contribution  to  medical  lit- 
erature that  comes  to  us  from  Salerno  bears  the  title, 
"  The  Coming  of  a  Physician  to  His  Patient,  or  An 
Instruction  for  the  Physician  Himself.' '  We  have 
had  a  number  of  such  works  published  in  recent 
years,  but  it  is  a  little  surprising  to  have  the  subject 
taken  up  thus  early  in  the  history  of  modern  pro- 
fessional life.  It  is  an  extremely  valuable  document, 
as  demonstrating  how  practical  was  the  teaching  at 
Salerno.     The  work  is  usually  ascribed  to  Archi- 


160  OLD-TIME  MAKERS  OF  MEDICINE 

mattheas,  and  it  certainly  gives  a  vivid  picture  of 
the  medical  customs  of  the  time.  The  instruction  for 
the  immediate  coming  of  the  physician  to  his  patient 
runs  as  follows : ' '  When  the  doctor  enters  the  dwell- 
ing of  his  patient,  he  should  not  appear  haughty, 
nor  covetous,  but  should  greet  with  kindly,  modest 
demeanor  those  who  are  present,  and  then  seating 
himself  near  the  sick  man  accept  the  drink  which  is 
offered  him  (sic)  and  praise  in  a  few  words  the 
beauty  of  the  neighborhood,  the  situation  of  the 
house,  and  the  well-known  generosity  of  the  family, — 
if  it  should  seem  to  him  suitable  to  do  so.  The  pa- 
tient should  be  put  at  his  ease  before  the  examination 
begins  and  the  pulse  should  be  felt  deliberately  and 
carefully.  The  fingers  should  be  kept  on  the  pulse  at 
least  until  the  hundredth  beat  in  order  to  judge  its 
kind  and  character;  the  friends  standing  round  will 
be  all  the  more  impressed  because  of  the  delay  and 
the  physician's  words  will  be  received  with  just  that 
much  more  attention.' ' 

The  old  physician  evidently  realized  very  well  how 
much  influence  on  the  patient's  mind  meant  for  the 
course  of  the  disease.  For  instance,  he  recommends 
that  the  patient  should  be  asked  to  confess  and  re- 
ceive the  sacraments  of  the  Church  before  the  doc- 
tor sees  him,  for  if  mention  is  afterwards  made  of 
this  the  patient  may  believe  that  it  is  because  the 
doctor  thinks  that  there  is  no  hope  for  him.  For 
the  purpose  of  producing  an  effect  upon  the  patient's 
mind,  the  old  physician  does  not  hesitate  even  to 
suggest  the  taking  advantage  of  every  possible 
source  of  information,  so  as  to  seem  to  know  all  about 
the  case.    "  On  the  way  to  see  the  sick  person  he 


THE  MEDICAL  SCHOOL  AT  SALERNO  161 

[the  physician]  should  question  the  messenger  who 
has  summoned  him  upon  the  circumstances  and  the 
conditions  of  the  illness  of  the  patient;  then,  if  not 
able  to  make  any  positive  diagnosis  after  examining 
the  pulse  and  the  urine,  he  will  at  least  excite  the 
patient's  astonishment  by  his  accurate  knowledge 
of  the  symptoms  of  the  disease  and  thus  win  his 
confidence. ' ' 

At  the  end  of  these  preliminary  instructions  there 
is  a  rather  diplomatic — to  say  the  least — bit  of  ad- 
vice that  might  perhaps  to  a  puritanic  conscience 
seem  more  politic  than  truthful.  Since  the  old  pro- 
fessor insists  so  much  on  not  disturbing  the  pa- 
tient's mind  by  a  bad  prognosis  or  any  hint  of  it, 
and  since  even  some  exaggeration  of  what  he  might 
think  to  be  the  serious  outlook  of  the  case  to  friends 
would  only  lead  to  greater  care  of  the  patient,  there 
is  probably  much  more  justification  for  his  sugges- 
tion than  might  be  thought  at  first  glance.  He  says, 
' '  When  the  doctor  quits  the  patient  he  should  prom- 
ise him  that  he  will  get  quite  well  again,  but  he 
should  inform  his  friends  that  he  is  very  ill ;  in  this 
way,  if  a  cure  is  affected,  the  fame  of  the  doctor 
will  be  so  much  the  greater,  but  if  the  patient  dies 
people  will  say  that  the  doctor  had  foreseen  the  fatal 
issue." 

The  story  of  the  medical  school  of  Salerno,  even 
thus  briefly  and  fragmentary  told,  illustrates  very 
well  how  old  is  the  new  in  education, — even  in  medi- 
cal education.  There  is  scarcely  a  phase  of  modern 
interest  in  medical  education  that  may  not  be  traced 
very  clearly  at  Salerno  though  the  school  began  its 
career  a  thousand  years  ago,  and  ceased  to  attract 


162  OLD-TIME  MAKERS  OF  MEDICINE 

much  attention  over  six  hundred  years  ago.  We  owe 
most  of  our  knowledge  of  the  details  of  its  organiza- 
tion and  teaching  to  De  Benzi.  Without  the  devo- 
tion of  so  ardent  a  scholar  it  would  have  been  almost 
impossible  for  us  to  have  attained  so  complete  a  pic- 
ture of  Salernitan  activities.  As  it  is,  as  a  conse- 
quence of  his  work  we  are  able  to  see  this  first  of 
modern  medical  schools  developing  very  much  as  do 
our  most  modern  medical  schools.  There  has  been 
an  accumulation  of  medical  information  in  the  thou- 
sand years,  but  the  ways  and  modes  of  facing  prob- 
lems and  many  of  the  solutions  of  them  do  not  differ 
from  what  they  were  in  the  distant  past.  The  more  | 
we  know  about  any  particular  period,  the  more  is  this  i 
brought  home  to  us.  It  is  for  this  that  study  of  par-  [ 
ticular  periods  and  institutions  of  the  olden  time,  as 
of  Salerno,  grows  increasingly  interesting,  because 
each  new  detail  helps  to  fill  in  sympathetically  the 
new-old  picture  of  human  activity  as  it  may  be  seen 
at  all  times. 


VII 

CONSTANTINE  AFBICANUS 

Probably  the  most  important  representative  of 
the  medical  school  at  Salerno,  certainly  the  most 
significant  member  of  its  faculty,  if  we  consider  the 
wide  influence  for  centuries  after  his  time  that  his 
writings  had,  was  Constantine  Africanus.  He  is  in- 
teresting, too,  for  many  other  reasons,  for  he  is  the 
first  representative,  in  modern  times,  that  is,  who, 
after  the  incentive  of  antiquity  had  passed,  devoted 
himself  to  creating  a  medical  literature  by  transla- 
tions, by  editions,  and  by  the  collation  of  his  own 
and  others'  observations  on  medical  subjects.  He 
is  the  connecting  link  between  Arabian  medicine  and 
Western  medical  studies.  The  fact  that  he  was  first 
a  traveller  over  most  of  the  educational  world  of  his 
time,  then  a  professor  at  the  University  of  Salerno 
who  attracted  many  students,  and  finally  a  Bene- 
dictine monk  in  the  great  abbey  at  Monte  Cassino, 
shows  how  his  life  ran  the  gamut  of  the  various 
phases  of  interest  in  the  intellectual  world  of  his 
time.  It  was  his  retirement  to  the  famous  mon- 
astery that  gave  him  the  opportunity,  the  leisure, 
the  reference  library  for  consultation  that  a  writer 
feels  he  must  have  near  him,  and  probably  also  the 
means  necessary  for  the  publication  of  his  works. 
Not  only  did  the  monks  of  Monte  Cassino  itself  de- 

163 


164  OLD-TIME  MAKERS  OF  MEDICINE 

vote  themselves  to  the  copying  of  his  many  books, 
but  other  Benedictine  monasteries  in  various  parts 
of  the  world  made  it  a  point  to  give  wide  diffusion 
to  his  writings. 

As  a  study  in  successful  publication,  that  is,  in 
the  securing  of  wide  attention  to  writings  within  a 
short  time,  the  career  of  Constantine  and  the  story 
of  his  books  would  be  extremely  interesting. 
Medieval  distribution  of  books  is  usually  thought  to 
have  been  rather  halting,  but  here  was  an  exception. 
It  was  largely  because  Benedictines  all  over  the 
world  were  deeply  interested  in  what  this  brother 
Benedictine  was  writing  that  wide  distribution  was 
secured  for  his  work  within  a  very  short  time.  His 
superiors  among  the  Benedictines  had  a  profound 
interest  in  what  he  was  doing.  The  great  Bene- 
dictine Abbot  Desiderius  of  Monte  Cassino,  who 
afterwards  became  Pope,  used  all  of  his  extensive 
influence  in  both  positions  to  secure  an  audience  for 
the  books — hence  the  many  manuscript  copies  of 
his  writings  that  we  have.  It  is  probable  that  Con- 
stantine established  a  school  of  writers  at  Monte 
Cassino,  for  he  could  scarcely  have  accomplished  so 
much  by  himself  as  has  been  attributed  to  him.  Be- 
sides, his  works  attracted  so  much  attention  that 
writers  of  immediately  succeeding  generations  who 
wanted  to  secure  attention  for  their  works  some- 
times attributed  them  to  him  in  order  to  take  ad- 
vantage of  his  popularity.  It  is  rather  difficult, 
then,  to  determine  with  absolute  assurance  which 
are  Constantine 's  genuine  works.  Some  of  those 
attributed  to  him  are  undoubtedly  spurious.  What 
we    know    with    certainty,    however,    is    that    his 


CONSTANTINE  AFRICANUS  165 

authentic  works  meant  much  for  his  own  and  after 
generations. 

Constantine  was  born  in  the  early  part  of  the  elev- 
enth century,  and  died  near  its  close,  having  lived 
probably  well  beyond  eighty  years  of  age,  his  years 
running  nearly  parallel  with  his  century.  His  sur- 
name, Africanus,  is  derived  from  his  having  been 
born  in  Africa,  his  birthplace  being  Carthage.  Early 
in  life  he  seems  to  have  taken  up  with  ardor  the 
study  of  medicine  in  his  native  town,  devoting  him- 
self, however,  at  the  same  time  to  whatever  of  phys- 
ical science  was  available.  Like  many  another 
young  man  since  his  time,  not  satisfied  with  the 
knowledge  he  could  secure  at  home,  he  made  distant 
journeys,  gathering  medical  and  scientific  informa- 
tion of  all  kinds  wherever  he  went.  According  to 
a  tradition  that  seems  to  be  well  grounded,  some  of 
these  journeys  took  him  even  into  the  far  East. 
During  his  travels  he  became  familiar  with  a  num- 
ber of  Oriental  languages,  and  especially  studied 
the  Arabian  literature  of  science  very  diligently. 

At  this  time  the  Arabs,  having  the  advantage  of 
more  intimate  contact  with  the  Greek  medical  tradi- 
tions in  Asia  Minor,  were  farther  advanced  in  their 
knowledge  of  the  medical  sciences  than  the  scholars 
in  the  West.  They  had  better  facilities  for  obtain- 
ing the  books  that  were  the  classics  of  medicine,  and, 
with  any  desire  for  knowledge,  could  scarcely  fail 
to  secure  it. 

What  was  best  in  Arabian  medicine  was  brought 
to  Salerno  by  Constantine  and,  above  all,  his  trans- 
lation of  many  well-known  Arabian  medical  authors 
proved  eminently  suggestive  to  seriously  investigat- 


166  OLD-TIME  MAKERS  OF  MEDICINE 

ing  physicians  all  over  the  world  in  his  time.  Be- 
fore he  was  to  be  allowed  to  settle  down  to  his 
literary  work,  however,  Constantine  was  to  have  a 
very  varied  experience.  Some  of  this  doubtless  was 
to  be  valuable  in  enabling  him  to  set  the  old  Arabian 
teachers  of  medicine  properly  before  his  generation. 
After  his  Oriental  travels  he  returned  to  his  native 
Carthage  in  order  to  practise  medicine.  It  was  not 
long,  however,  before  his  superior  medical  knowl- 
edge, or,  at  least,  the  many  novelties  of  medical 
practice  that  he  had  derived  from  his  contact  with 
the  East,  drew  upon  him  the  professional  jealousy 
of  his  colleagues.  It  is  very  probable  that  the  repu- 
tation of  his  extensive  travels  and  wide  knowledge 
soon  attracted  a  large  clientele.  This  was  followed 
quite  naturally  by  the  envy  at  least  of  his  pro- 
fessional brethren.  Feeling  became  so  bitter,  that 
even  the  possibility  of  serious  personal  conse- 
quences for  him  because  of  false  accusations  was 
not  out  of  the  question.  Whenever  novelties  are 
introduced  into  medical  science  or  medical  practice, 
their  authors  are  likely  to  meet  with  this  opposition 
on  the  part  of  colleagues,  and  history  is  full  of  ex- 
amples of  it.  Galvani  was  laughed  at  and  called  the 
frogs'  dancing-master;  Auenbrugger  was  made  fun 
of  for  drumming  on  people ;  Harvey  is  said  to  have 
lost  half  of  his  consulting  practice ; — all  because  they 
were  advancing  ideas  that  their  contemporaries 
were  not  ready  to  accept.  We  are  rather  likely  to 
think  that  this  intolerant  attitude  of  mind  belongs 
to  the  older  times,  but  it  is  rather  easy  to  trace  it  in 
our  own. 
In  Constantine 's  day  men  had  ready  to  hand  a 


CONSTANTINE  AFRICANUS  167 

very  serious  weapon  that  might  be  used  against  in- 
novators. By  craftily  circulated  rumors  the  pop- 
ulace was  brought  to  accuse  him  of  magical  prac- 
tices, that  is,  of  producing  his  cures  by  association 
with  the  devil.  We  are  rather  prone  to  think  little 
of  a  generation  that  could  take  such  nonsense  seri- 
ously, but  it  would  not  be  hard  to  find  analogous 
false  notions  prevalent  at  the  present  time,  which 
sometimes  make  life  difficult,  if  not  dangerous,  for 
well-meaning  individuals.1  Life  seems  to  have  been 
made  very  uncomfortable  for  Constantine  in 
Carthage.  Just  the  extent  to  which  persecution 
went,  however,  we  do  not  know.  About  this  time 
Constantine's  work  attracted  the  attention  of  Duke 
Eobert  of  Salerno.  He  invited  him  to  become  his 
physician.  After  he  had  filled  the  position  for  a  time 
a  personal  friendship  developed,  and,  as  has  often 
happened  to  the  physicians  of  kings,  he  became  a 
royal  counsellor  and  private  secretary.  When  the 
post  of  professor  of  medicine  at  Salerno  fell  vacant, 
it  is  not  surprising,  then,  that  Constantine  should 
have  been  made  professor,  and  from  here  his  teach- 
ing soon  attracted  the  attention  of  all  the  men  of 
his  time. 

Constantine  seems  to  have  greatly  enhanced  the 
reputation  of  the  medical  school,  and  added  to  the 
medical  prestige  of  Salerno.  After  teaching  for  some 
ten  years  there,  however,  he  gave  up  his  professor- 
ship— the  highest  position  in  the  medical  world  of 
the  time — apparently  with  certain  plans  in  mind. 

JThe  first  dentist  who  filled  teeth  with  amalgam  in  New  York, 
some  eighty  years  ago,  had  to  flee  for  his  life,  because  of  a  hue  and 
cry  set  up  that  he  was  poisoning  his  patients  with  mercury. 


168  OLD-TIME  MAKERS  OF  MEDICINE 

He  wanted  leisure  for  writing  the  many  things  in 
medicine  that  he  had  learned  in  his  travels  in  the 
East,  so  as  to  pass  his  precious  treasure  of  knowl- 
edge on  to  succeeding  generations ;  and  then,  too,  he 
seems  to  have  longed  for  that  peace  that  would 
enable  him  not  only  to  do  his  writing  undisturbed, 
but  to  live  his  life  quietly  far  away  from  the  strife 
of  men  and  the  strenuous  existence  of  a  court  and  of 
a  great  school. 

There  was  probably  another  and  more  intimate 
personal  reason  for  his  retirement.  Abbot  Desi- 
derius  of  the  Benedictine  Abbey  of  Monte  Cassino, 
not  far  away,  had  become  a  close  and  valued  friend. 
Before  having  been  made  abbot,  Desiderius  and 
Constantine  probably  were  fellow  professors  at 
Salerno,  for  we  know  that  Desiderius  himself  and 
many  of  his  fellow  Benedictines  taught  in  the  under- 
graduate department  there.  Desiderius  enjoyed 
the  reputation  of  being  one  of  the  most  learned  men 
of  the  time  when  his  election  to  the  abbacy  at  Monte 
Cassino  took  him  away  from  Salerno.  His  de- 
parture was  a  blow  to  Constantine,  who  had  learned 
by  years  of  friendship  that  to  be  near  his  intimate 
friend,  the  pious  scholarly  Benedictine,  was  a  solace 
in  life  and  a  never  failing  incentive  to  his  own  in- 
tellectual work.  Desiderius  seems,  indeed,  to  have 
been  a  large  factor  in  influencing  the  great  physi- 
cian to  write  his  books  rather  than  devote  himself  to 
oral  teaching,  since  the  circulation  of  his  writing 
would  confer  so  much  more  of  benefit  on  a  greater 
number  of  people.  Perhaps  another  element  in  the 
situation  was  that  Desiderius  was  desirous  of  hav- 
ing the  learned  physician,  the  travelled  scholar,  at 


CONSTANTINE  AFBICANUS  169 

Monte  Cassino,  for  the  sake  of  his  influence  on  the 
scholarship  of  the  abbey,  and  for  the  incentive  that 
he  would  be  to  the  younger  monks  to  apply  them- 
selves to  the  varied  field  of  knowledge  which  the 
Benedictines  had  chosen  for  themselves  at  this  time. 

Whatever  hopes  of  mutual  solace  and  helpfulness 
and  of  the  joys  of  intimate  close  friendship  may 
have  been  in  the  minds  of  these  two  most  learned 
men  of  their  time,  they  were  destined  to  be  grievously 
disappointed.  Only  a  few  years  after  Constantine  's 
entrance  into  the  monastery  at  Monte  Cassino  Desi- 
derius  was  elected  Pope.  The  humble  Benedictine 
did  not  want  to  take  the  exalted  position,  but  it  was 
plainly  shown  to  him  that  it  was  his  duty,  and  that 
he  must  not  shirk  it.  Accordingly,  under  the  name 
of  Pope  Victor  III,  he  became  one  of  the  great 
Popes  of  the  eleventh  century.  One  might  think 
that  he  could  have  summoned  Constantine  to  Eome, 
but  perhaps  he  knew  that  his  friend  would  prefer 
the  quietude  of  the  cloister,  and  then,  too,  probably 
he  wanted  to  allow  him  the  opportunity  to  accom- 
plish that  writing  for  which  Constantine  and  him- 
self had  planned  when  the  great  physician  entered 
the  monastery. 

All  that  we  know  for  sure  is  that  some  twenty 
years  of  Constantine 's  life  were  spent  as  a  monk  in 
Monte  Cassino,  where  he  devoted  his  time  mainly 
to  the  writing  of  his  books.  One  bond  of  union  there 
was.  Each  of  the  works,  as  soon  as  completed, 
was  sent  off  to  the  Pope  as  long  as  he  lived.  On 
the  other  hand,  though  busy  with  his  Papal  duties, 
Pope  Victor  constantly  stimulated  Constantine,  even 
from  distant  Rome,  to  go  on  with  his  work.     There 


170  OLD-TIME  MAKERS  OF  MEDICINE 

were  messages  of  brotherly  interest  and  solicitude 
just  as  in  the  old  days.  The  great  African  physi- 
cian^ best  known  work,  the  so-called  "  Liber  Pan- 
tegni, ' '  which  is  really  a  translation  of  the  ' '  Khitaab 
el  Maleki  "  of  Ali  Ben  el- Abbas,  is  dedicated  to  Desi- 
derius.  Constantine  wrote  a  number  of  other  books, 
most  of  them  original,  but  it  is  difficult  now  to  de- 
cide just  which  of  those  that  pass  under  his  name 
are  genuine.  Many  were  subsequently  attributed  to 
him  that  are  surely  not  his. 

These  translators  of  the  Middle  Ages  proved  to 
be  not  only  the  channels  through  which  informa- 
tion came  to  their  generations,  but  they  were  also 
incentives  to  study  and  investigation.  It  is  when 
men  can  get  a  certain  amount  of  information  rather 
easily  that  they  are  tempted  to  seek  further  in 
order  to  solve  the  problems  that  present  themselves. 
There  are  three  great  translators  whose  work  meant 
much  for  the  Middle  Ages  at  this  time.  They  were, 
besides  Constantine  in  the  eleventh  century,  Gerard 
of  Cremona,  in  the  twelfth,  and  the  Jewish  Faradj 
Ben  Salim,  at  Naples,  in  the  thirteenth.  Gerard  did 
in  Spain  for  the  greater  Arabian  writers  what  Con- 
stantine had  accomplished  for  those  of  lesser  im- 
port. Under  the  patronage  of  the  Emperor  Fred- 
erick Barbarossa,  he  published  translations  of 
Ehazes,  Isaac  Judaeus,  Serapion,  Abulcasis,  and  Avi- 
cenna.  His  work  was  done  in  Toledo,  the  city  in 
which,  during  the  twelfth  and  thirteenth  centuries, 
so  many  translators  were  at  work  making  books  for 
the  Western  world. 

Constantine  did  much  more  than  merely  bring  out 
his  translations  of  Arabian  works.  He  gave  a  zest  to 


CONSTANTINE  AFRICANUS  171 

the  study  of  the  old  masters,  issued  editions  of  cer- 
tain, at  least,  of  the  works  of  Hippocrates  ("  Apho- 
risms ")  and  Galen  ("  Microtechnics  "),  and,  in  gen- 
eral, called  attention  to  the  precious  treasure  of  med- 
ical lore  that  must  be  used  to  advantage  if  men  were 
to  teach  the  rising  generation  out  of  the  accumulated 
knowledge  of  the  past.  Pagel,  in  Puschmann's 
11  Handbook,' '  does  not  hesitate  to  say  that  "  a 
farther  merit  of  Constantine  must  be  recognized, 
inasmuch  as  that  not  long  after  his  career  the  sec- 
ond epoch  of  the  school  of  Salerno  begins,  marked 
not  only  by  a  wealth  of  writers  and  writings  on 
medicine,  but,  above  all,  because  from  this  time  on 
the  study  of  Greek  medicine  received  renewed  en- 
couragement through  the  Latin  versions  of  the 
Arabian  literature.  We  may  think  as  we  will  of 
the  worth  of  these  works,  but  this  much  is  sure,  that 
in  many  ways  they  brought  about  a  broadening 
and  an  improvement  of  Greek  knowledge,  especially 
from  the  pharmacopeia  standpoint. ' ' 

Probably  the  best  evidence  that  we  have  for  Con- 
stantine 's  influence  on  his  generation  is  to  be  found 
in  what  was  accomplished  by  men  who  acknowledged 
with  pride  that  he  was  their  master,  and  who 
thought  it  a  mark  of  distinction  to  be  reckoned  as 
his  disciples. 

Among  these  especially  noteworthy  is  Johannes 
Afflacius,  or  Saracenus  (whose  surname  of  the  Sara- 
cen probably  means  that  he,  too,  came  from  Africa, 
as  his  master  did).  He  was  the  author  of  two 
treatises  on  "  Fevers  and  Urines,"  and  the  so- 
called  "  Cures  of  Afflacius.' '  Some  of  these  cures  he 
directly  attributed  to  Constantine.    Then  there  is  a 


172  OLD-TIME  MAKERS  OF  MEDICINE 

Bartholomew  who  wrote  a  ' '  Practica,  "or"  Manual 
of  the  Practice  of  Medicine/ '  with  the  sub-title, 
"  Introductions  to  and  Experiments  in  the  Medical 
Practice  of  Hippocrates,  Constantine,  and  the  Greek 
Physicians."  Bartholomew  represents  himself  as  a 
disciple  of  Constantine.  This  "  Practica  "  of 
Bartholomew  was  one  of  the  most  commonly  used 
books  of  the  twelfth  and  thirteenth  centuries 
throughout  Europe.  There  are  manuscript  com- 
mentaries and  translations,  and  abstracts  from  it 
not  only  in  the  Latin  tongues,  but  especially  in  the 
Teutonic  languages.  Pagel  refers  to  manuscripts 
in  High  and  Low  Dutch,  and  even  in  Danish.  The 
Middle  High  Dutch  manuscripts  of  this  * '  Practica  ' ' 
of  Bartholomew  come  mainly  from  the  thirteenth 
century,  and  have  not  only  a  special  interest  be- 
cause of  their  value  in  the  history  of  philology,  but 
because  they  are  the  main  sources  of  all  the  later 
books  on  drugs  which  appeared  in  very  large  num- 
bers in  German.  They  have  a  very  great  historico- 
literary  interest,  especially  for  pharmacology. 

To  Afflacius  we  owe  a  description  of  a  method  of 
reducing  fever  that  is  not  only  ingenious,  but,  in 
the  light  of  our  recently  introduced  bathing  methods 
for  fever,  is  a  little  startling.  In  his  book  on 
"  Fevers  and  Urines,"  Afflacius  suggests  that  when 
the  patient's  fever  makes  him  very  restless,  and 
especially  if  it  is  warm  weather,  a  sort  of  shower 
bath  should  be  given  to  him.  He  thought  that  rain 
water  was  the  best  for  this  purpose,  and  he  de- 
scribes its  best  application  as  in  rainy  fashion,  modo 
pluviali.  The  water  should  be  allowed  to  flow  down 
over  the  patient  from  a  vessel  with  a  number  of 


CONSTANTINE  AFEICANUS  173 


minute  perforations  in  the  bottom.  A  number  of 
the  practical  hints  for  treatment  given  by  Afflacius 
have  been  attributed  to  Constantine. 

Constantine 's  reputation  has,  in  the  opinion  of 
some  writers,  been  hurt  by  two  features  of  his  pub- 
lished works,  as  they  have  come  to  us,  that  we  find 
it  difficult  to  understand.  One  of  these  is  that  his 
translations  from  the  Arabic  were  made  mainly 
not  of  the  books  of  the  great  leaders  of  Arabian 
medicine,  but  from  certain  of  the  less  important 
writers.  The  other  is  that  it  does  not  seem  always 
to  have  been  made  clear  in  the  manuscripts  that 
have  come  down  to  us,  whether  these  writings  were 
translations  or  original  writings.  Some  have  even 
gone  so  far  as  to  suggest  that  Constantine  himself 
would  have  been  quite  willing  to  receive  the  credit 
for  these  writings. 

As  to  the  first  of  these  objections,  it  may  be  said 
that  very  probably  Constantine,  in  his  travels,  had 
come  to  realize  that  the  books  of  the  great  Arabian 
physicians,  Ehazes,  Abulcasis,  Avicenna,  and  others, 
already  received  so  much  attention  that  the  best 
outlook  for  medicine  was  to  call  particular  notice 
to  the  writings  of  such  lesser  lights  as  Ali  Abbas, 
Isaac  Judaeus,  Abu  Dschafer,  and  others  of  even 
less  note.  Certainly  we  cannot  but  feel  that  his 
judgment  in  the  matter  must  have  been  directed 
by  reasons  that  we  may  not  be  able  to  understand  at 
present,  but  that  must  have  existed,  for  all  that 
we  know  of  the  man  proves  his  character  as  a  prac- 
tical, far-sighted  scholar.  Besides,  it  seems  not  un- 
likely that  but  for  his  interest  in  them  we  would  not 
at  the  present  time  possess  the  translations  of  these 


174  OLD-TIME  MAKERS  OF  MEDICINE 

minor  Arabian  writers,  and  that  would  be  an  un- 
fortunate gap  in  medical  history. 

The  other  misunderstanding  with  regard  to  Con- 
stantine  refers  to  the  fact  that  it  is  now  almost  im- 
possible to  decide  which  are  his  own  and  which  are 
the  writings  of  others.  It  has  been  said  that  he 
even  tried  to  palm  off  some  of  the  writings  of  others 
as  his  own.  This  seems  extremely  unlikely,  how- 
ever, knowing  all  that  we  do  about  his  life ;  and  the 
suspicion  is  founded  entirely  on  manuscripts  as  we 
have  them  at  the  present  time,  about  a  thousand 
years  after  he  lived.  "What  mutilations  these  manu- 
scripts underwent  in  the  course  of  various  copyings 
is  hard  now  to  estimate.  Monastic  copyists  might 
very  well  have  left  out  Arabian  names,  because  they 
were  mainly  interested  in  the  fact  that  they  were 
providing  for  their  readers  works  that  had  received 
the  approval  of  Constantine,  and  the  translation  of 
which  at  least  had  been  made  under  his  direction. 
It  is  quite  clear  that  he  did  not  do  all  the  translat- 
ing himself,  and  that  he  probably  must  have  organ- 
ized a  school  of  medical  translators  at  Monte  Cas- 
sino.  Then  just  how  the  various  works  would  be 
looked  at  is  very  dubious.  Undoubtedly  many  of  the 
translations  were  done  after  his  death,  or  certainly 
finished  after  his  time,  and  at  last  attributed  to 
him,  because  he  was  the  moving  spirit  and  had  prob- 
ably selected  the  books  that  should  be  translated,  and 
made  suggestions  with  regard  to  them.  For  all  of 
his  monks  he  was,  as  masters  have  ever  been  for 
disciples,  much  more  important,  and  rightly  so,  than 
those  writers  to  whom  he  referred  them. 

The    whole    question    of    plagiarism    in    these 


CONSTANTINE  AFBICANUS  175 

medieval  times,  as  I  have  pointed  out  elsewhere,  is 
entirely  different  from  that  of  the  present  time. 
Now  a  writer  may  consciously  or  unconsciously 
claim  another  writing  as  his  own.  We  have  come 
to  a  time  when  men  think  much  of  their  individual 
reputations.  It  was  no  uncommon  thing,  however, 
in  the  Middle  Ages,  and  even  later  in  the  Benais- 
sance,  for  a  writer  to  attribute  what  he  had  writ- 
ten to  some  distinguished  literary  man  of  the  pre- 
ceding time,  and  sign  that  writer's  name  to  his  own 
work.  The  idea  of  the  later  author  was  to  secure 
an  audience  for  his  thoughts.  He  seemed  to  be  quite 
indifferent  whether  people  ever  knew  just  who  the 
writer  was,  but  he  wanted  to  influence  humanity  by 
his  writings.  He  thought  much  more  of  this  than 
of  any  possible  reputation  that  might  come  to  him. 
Of  course,  there  was  no  question  of  money.  There 
never  has  been  any  question  of  money-making  when- 
ever the  things  written  have  been  really  worth  while. 
Literature  that  has  deeply  influenced  mankind  has 
never  paid.  Publications  that  have  paid  are  insig- 
nificant works  that  have  touched  superficially  a  whole 
lot  of  people.  To  think  of  Constantine  as  a  pla- 
giarist in  our  modern  sense  of  the  word,  as  trying 
to  take  the  credit  for  someone  else's  writings,  is  to 
misunderstand  entirely  the  times  in  which  he  lived, 
and  to  ignore  the  real  problem  of  plagiarism  at  that 
time. 

With  the  accumulation  of  information  with  re- 
gard to  the  history  of  medicine  in  his  time,  Con- 
stantine 's  reputation  has  been  constantly  enhanced. 
It  is  not  so  long  since  he  was  considered  scarcely 
more  than  a  monkish  chronicler,  who  happened  to 


176  OLD-TIME  MAKERS  OF  MEDICINE 

have  taken  medicine  rather  than  history  for  his 
field  of  work.  Gradually  we  have  come  to  appre- 
ciate all  that  he  did  for  the  medicine  of  his  time. 
Undoubtedly  his  extensive  travels,  his  wide  knowl- 
edge, and  then  his  years  of  effort  to  make  Oriental 
medicine  available  for  the  Western  civilization  that 
was  springing  up  again  among  the  peoples  who  had 
come  to  replace  the  Eomans,  set  him  among  the 
great  intellectual  forces  of  the  Middle  Ages. 
Salerno  owed  much  to  him,  and  it  must  not  be  for- 
gotten that  Salerno  was  the  first  university  of  mod- 
ern times,  and,  above  all,  the  first  medical  school 
that  raised  the  dignity  of  the  medical  profession, 
established  standards  of  medical  education,  edu- 
cated the  public  mind  and  the  rulers  of  the  time  to 
the  realization  of  the  necessity  for  the  regulation 
of  the  practice  of  medicine,  and  in  many  ways  an- 
ticipated our  modern  professional  life.  That  the 
better  part  of  his  life  work  should  have  been  done 
as  a  Benedictine  only  serves  to  emphasize  the  place 
that  the  religious  had  in  the  preservation  and  the 
development  of  culture  and  of  education  during  the 
Middle  Ages. 


VIII 
MEDIEVAL  WOMEN  PHYSICIANS 

Very  probably  the  most  interesting  chapter  for 
us  of  the  modern  time  in  the  history  of  the  medical 
school  at  Salerno  is  to  be  found  in  the  opportunities 
provided  for  the  medical  education  of  women  and 
the  surrender  to  them  of  a  whole  department  in  the 
medical  school,  that  of  Women's  Diseases.  While 
it  is  probable  that  Salerno  did  not  owe  its  origin 
to  the  Benedictines,  and  it  is  even  possible  that  there 
was  some  medical  teaching  there  for  all  the  cen- 
turies of  the  Middle  Ages  from  the  Greek  times,  for 
it  must  not  be  forgotten  that  this  part  of  Italy  was 
settled  by  Greeks,  and  was  often  called  Magna 
Graecia,  there  is  no  doubt  at  all  that  the  Bene- 
dictines exercised  great  influence  in  the  counsels 
of  the  school,  and  that  many  of  the  teachers  were 
Benedictines,  as  were  also  the  Archbishops,  who 
were  its  best  patrons,  and  the  great  Pope  Victor  III, 
who  did  much  for  it.  For  several  centuries  the 
Benedictines  represented  the  most  potent  influence 
at  Salerno. 

For  most  people  who  are  not  intimately  familiar 
with  monastic  life,  and,  above  all,  with  the  story 
of  the  Benedictines,  their  prestige  at  Salerno  might 
seem  to  be  enough  of  itself  to  preclude  all  possibility 
of  the  education  of  women  in  medicine  at  Salerno. 
For  those  who  know  the  Benedictines  well,  however, 

177 


178  OLD-TIME  MAKERS  OF  MEDICINE 

such  a  departure  as  the  accordance  of  opportunities 
for  women  to  study  medicine  would  seem  eminently 
in  keeping  with  the  practical  wisdom  of  their  rules 
and  the  development  of  their  work.  From  the  be- 
ginning the  Benedictines  recognized  that  a  monastic 
career  should  be  open  to  women  as  well  as  to  men, 
and  Benedict's  sister,  Scholastica,  established  con- 
vents for  them,  as  her  brother  did  the  Benedictine 
monasteries,  thus  providing  a  vocation  for  women 
who  did  not  feel  called  upon  to  marry.  That  the 
members  of  the  order  should  recognize  the  advisabil- 
ity of  affording  women  the  opportunity  to  study 
medicine,  and  of  handing  over  to  them  the  depart- 
ment of  women's  diseases  in  a  medical  school  in 
which  they  had  a  considerable  amount  of  authority, 
seems,  then,  indeed,  only  what  might  have  been  ex- 
pected of  them. 

We  are  prone  in  the  modern  time  to  think  that 
our  generation  is  the  first  to  offer  to  women  any 
facilities  or  opportunities  for  education  in  medicine. 
We  are  prone,  however,  just  in  the  same  way,  to 
consider  that  a  number  of  things  that  we  are  doing 
are  now  being  done  for  the  first  time.  As  a  matter 
of  fact,  it  is  extremely  difficult  to  find  any  im- 
portant movement  or  occupation  that  is  not  merely 
a  repetition  of  a  previous  interest  of  mankind.  The 
whole  question  of  feminine  education  we  are  apt  to 
think  of  as  modern,  forgetting  that  Plato  insisted 
in  his  "  Bepublic,"  as  absolutely  as  any  modern  fem- 
inist, that  women  should  have  the  same  opportuni- 
ties for  education  as  men,  and  that  at  Borne,  at  the 
end  of  the  Bepublic  and  the  beginning  of  the  Em- 
pire, the  women  occupied  very  much  the  same  posi- 


MEDIEVAL  WOMEN  PHYSICIANS  179 

tion  in  social  life  as  our  own  at  the  present  time. 
Their  husbands  supplied  the  funds,  and  they 
patronized  the  artists,  gave  receptions  to  the  poets, 
lionized  the  musicians,  and,  in  general,  ' '  went  after 
culture  "  in  a  way  that  is  a  startling  reminder  of 
what  we  are  familiar  with  in  our  own  time.  Just  as 
soon  as  Christianity  began  to  influence  education, 
women  were  given  abundant  opportunities  for 
higher  education  in  all  forms.  In  Ireland,  the 
first  nation  completely  converted  to  Christianity, 
— where,  therefore,  the  national  policy  in  education 
could  be  shaped  by  the  Church  without  hindrance, — 
St.  B  rigid 's  school  at  Kildare  was  scarcely  less 
famous  than  St.  Patrick's  at  Armagh.  It  had  sev- 
eral thousand  students,  and,  to  a  certain  extent  at 
least,  co-education  existed.  In  Charlemagne's  time, 
with  the  revival  of  education  on  the  Continent,  the 
women  of  the  Imperial  Court  attended  the  Palace 
School,  as  well  as  the  men.  In  the  thirteenth  cen- 
tury we  find  women  professors  in  every  branch  at 
Italian  universities.  Some  of  them  were  at  least 
assistants  in  anatomy.  The  Eenaissance  women 
were,  of  course,  profoundly  educated.  In  a  word, 
we  have  many  phases  of  feminine  education,  though 
with  intervals  of  absolutely  negative  interest,  down 
the  centuries. 

There  had  evidently  been  quite  a  considerable 
amount  of  opportunity,  if  not  of  actual  encourage- 
ment, for  women  in  medicine,  both  among  the  Greeks 
and  the  Romans,  in  the  early  centuries  of  the  Chris- 
tian era.  Galen,  for  instance,  quotes  certain  pre- 
scriptions from  women  physicians.  One  Cleopatra 
is  said  to  have  written  a  book  on  cosmetics.    This 


180  OLD-TIME  MAKERS  OF  MEDICINE 

name  came  afterwards  to  be  confounded  with  that 
of  Queen  Cleopatra,  giving  new  prestige  to  the  book, 
but  neither  Galen  nor  Aetius,  the  early  Christian 
physician,  both  of  whom  quote  from  her  work,  speak 
of  her  as  anything  except  a  medical  writer.  Some 
monuments  to  women  physicians  from  these  old 
times  have  escaped  the  tooth  of  time.  There  was 
the  tomb  of  one  Basila,  and  also  of  a  Thecla,  both  of 
whom  are  said  to  have  been  physicians.  Two  other 
names  of  Greek  women  physicians  we  have,  Origenia 
and  Aspasia,  the  former  mentioned  by  Galen,  the 
latter  by  Aetius  in  his  "  Tetrabiblion. "  Darem- 
berg,  the  medical  historian,  announced  in  1851  that 
he  had  found  a  Greek  manuscript  with  the  title, 6 '  On 
Women's  Diseases,"  written  by  one  Metrodora,  a 
woman  physician.  He  promised  to  publish  it.  It 
was  unpublished  at  the  time  of  his  death,  but  could 
not  be  found  among  his  papers.  There  is  a  manu- 
script on  medical  subjects,  bearing  this  name,  men- 
tioned in  the  catalogue  of  the  Greek  Codices  of 
the  Laurentian  Library  at  Florence,  but  this  is  said 
to  give  no  indication  of  the  time  when  its  author 
lived.  We  have  evidence  enough,  however,  to  show 
that  Greek  women  physicians  were  not  very  rare. 

The  Eomans  imitated  the  Greeks  so  faithfully — 
one  might  almost  say  copied  them  so  closely — that  it 
is  not  surprising  to  find  a  number  of  Roman  women 
physicians.  The  first  mention  of  them  comes  from 
Scribonius  Largus,  in  the  first  century  after  Christ. 
Octavius  Horatianus,  whom  most  of  us  know  better 
as  Priscian,  dedicated  one  of  his  books  on  medicine 
to  a  woman  physician  named  Victoria.  The  dedica- 
tion leaves  no  doubt  that  she  was  a  woman  in  active 


MEDIEVAL  WOMEN  PHYSICIANS  181 

practice,  at  least  in  women's  diseases,  and  it  is  a 
book  on  this  subject  that  Priscian  dedicates  to  her. 
He  mentions  another  woman  physician,  Leoparda. 
The  word  medica  for  a  woman  physician  was  very 
commonly  used  at  Rome.  Martial,  whose  epigrams 
have  been  a  source  of  so  much  information  in  med- 
ical history,  especially  on  subjects  with  regard  to 
which  information  was  scanty,  mentions  a  medica 
in  an  epigram.  Apuleius  also  uses  the  word.  There 
are  a  number  of  inscriptions  in  which  women  physi- 
cians are  mentioned.  Among  the  Christians  we  find 
women  physicians,  and  Theodosia,  the  mother  of  St. 
Procopius,  the  martyr,  is  said  to  have  been  very 
successful  in  the  practice  of  both  medicine  and 
surgery.  She  is  numbered  among  the  martyrs,  and 
occurs  in  the  Roman  Martyrology  on  the  29th  of 
May.  Father  Bzowski,  the  Polish  Jesuit,  who  com- 
piled "  Nomenclatura  Sanctorum  Professione  Medi- 
corum  "  (Rome,  1621;  the  book  is  usually  catalogued 
under  the  Latin  form  of  his  name,  Bzovius),  has 
among  his  list  of  saints  who  were  physicians  by 
profession  a  woman,  St.  Nicerata,  who  lived  at  Con- 
stantinople in  the  reign  of  the  Emperor  Arcadius, 
and  who  is  said  to  have  cured  St.  John  Chrysostom 
of  a  serious  disease. 

The  organization  of  the  department  of  women's 
diseases  at  Salerno,  under  the  care  of  women  pro- 
fessors, and  the  granting  of  licenses  to  women  to 
practise  medicine,  is  not  so  surprising  in  the  light 
of  this  tradition  among  Greeks  and  Romans,  taken 
up  with  some  enthusiasm  by  the  Christians.  "We 
are  not  sure  just  when  this  development  took  place. 
The  first  definite  evidence  with  regard  to  it  comes 


182  OLD-TIME  MAKERS  OF  MEDICINE 

in  the  life  of  Trotula,  who  seems  to  have  been  the 
head  of  the  department.  Some  of  her  books  are 
well  known,  and  often  qnoted  from,  and  she  con- 
tributed to  a  symposium  on  the  treatment  of  disease, 
in  which  there  are  contributions,  also,  from  men 
professors  of  Salerno  at  the  time.  She  seems  to 
have  flourished  about  the  middle  of  the  eleventh 
century.  Ordericus  Vitalis,  a  monk  of  Utica,  who 
wrote  an  ecclesiastical  history,  tells  of  one  Eudolph 
Malcorona,  who,  in  1059,  came  to  Utica  and  re- 
mained there  for  a  long  time  with  Father  Eobert, 
his  nephew.  "  This  Eudolph  had  been  a  student 
all  his  life,  devoting  himself  with  great  zeal  to 
letters,  and  had  become  famous  for  his  visits  to  the 
schools  of  France  and  Italy,  in  order  to  gather  there 
the  secrets  of  learning.  As  a  consequence  he  was 
well  informed  not  only  in  grammar  and  dialectics, 
but  also  in  astronomy  and  in  music.  He  also  pos- 
sessed such  an  extensive  knowledge  of  the  natural 
sciences  that  in  the  town  of  Salerno,  where,  since 
ancient  times,  the  best  schools  of  medicine  had  ex- 
isted, there  was  no  one  to  equal  him  with  the  ex- 
ception of  a  very  wise  matron.' ' 

This  wise  matron  has  been  identified  with  Tro- 
tula, many  of  the  details  of  whose  life  have  been 
brought  to  light  by  De  Eenzi,  in  his  "  Story  of  the 
School  of  Salerno. ' '  *  According  to  very  old  tradi- 
tion, Trotula  belonged  to  the  family  of  Euggiero. 
This  was  a  noble  family  of  Salerno,  many  of  the 
members  of  which  were  distinguished  in  their  native 
town  at  least,  but  the  name  is  not  unusual  in  Italy, 

1"  Storia  de  la  Scuola  di  Salerno." 


MEDIEVAL  WOMEN  PHYSICIANS  183 

as  readers  of  Dante  and  Boccaccio  are  likely  to 
know.  It  was,  indeed,  as  common  as  our  own 
Eogers,  of  which  it  is  the  Italian  equivalent. 

De  Eenzi  has  made  out  a  rather  good  case  for  the 
tradition  that  Trotula  was  the  wife  of  John 
Platearius  I — so  called  because  there  were  probably 
three  professors  of  that  name.  Trotula  was,  ac- 
cording to  this,  the  mother  of  the  second  Platearius, 
and  the  grandmother  of  the  third,  all  of  them  dis- 
tinguished members  of  the  faculty  at  Salerno. 

Her  reputation  extended  far  beyond  her  native 
town,  and  even  Italy  itself,  and,  in  later  centuries, 
her  name  was  used  to  dignify  any  form  of  treat- 
ment for  women's  diseases  that  was  being  exploited. 
Eutebeuf,  one  of  the  trouveres,  thirteenth-century 
French  poets,  has  a  description  of  the  scene  in 
which  one  of  the  old  herbalist  doctors  who  used  to 
go  round  and  collect  a  crowd  by  means  of  songs 
and  music,  and  then  talk  medicine  to  them — just  as 
is  done  even  yet  in  many  of  the  smaller  towns  of 
this  country — is  represented  as  saying  to  the  crowd 
when  he  wants  to  make  them  realize  that  he  is  no 
ordinary  quacksalver,  that  he  is  one  of  the  disciples 
of  the  great  Madame  Trot  of  Salerno.  The  old- 
fashioned  speech  runs  somewhat  as  follows: 
"  Charming  people:  I  am  not  one  of  these  poor 
preachers,  nor  the  poor  herbalists,  who  carry  little 
boxes  and  sachets,  and  who  spread  out  before  them 
a  carpet.  I  am  the  disciple  of  a  great  lady,  who 
bears  the  name  of  Madame  Trot  of  Salerno.  And 
I  would  have  you  know  that  she  is  the  wisest  woman 
in  all  the  four  quarters  of  the  world." 

Two  books  are  attributed  to  Trotula;  one  bears 


184  OLD-TIME  MAKERS  OF  MEDICINE 

the  title,  "  De  Passionibus  Mulierum,"  and  the  other 
has  been  called  "  Trotula  Minor,"  or  "  Summula 
Secundum  Trotulam, ' '  and  is  a  compendium  of  what 
she  wrote.  This  is  probably  due  to  some  disciple, 
but  seems  to  have  existed  almost  in  her  own  time. 
Her  most  important  work  bears  two  sub-titles, 
"  Trotula 's  Unique  Book  for  the  Curing  of  Diseases 
of  Women,  Before,  During,  and  After  Labor,' '  and 
the  other  sub-title,  "  Trotula 's  Wonderful  Book  of 
Experience  {experiment alls)  in  the  Diseases  of 
Women,  Before,  During,  and  After  Labor,  with 
Other  Details  Likewise  Relating  to  Labor." 

The  book  begins  with  a  prologue  on  the  nature 
of  man  and  of  woman,  and  an  explanation  of  how 
the  author,  taking  pity  on  the  sufferings  of  women, 
came  to  devote  herself  to  the  study  of  their  diseases. 
There  are  many  interesting  details  in  the  book,  all 
the  more  interesting  because  in  many  ways  they  an- 
ticipate modern  solutions  of  difficult  problems  in 
women's  diseases,  and  the  care  of  the  mother  and 
child  before,  during,  and  after  labor.  For  instance, 
there  are  a  series  of  rules  on  the  choice  of  the  nurse, 
and  on  the  diet  and  the  regime  which  she  should 
follow  if  the  child  is  to  be  properly  nourished  with- 
out disturbance. 

Probably  the  most  striking  passage  in  her  book 
is  that  with  regard  to  a  torn  perineum  and  its  re- 
pair. This  passage  may  be  found  in  De  Renzi  or  in 
Gurlt.  It  runs  as  follows :  ' '  Certain  patients,  from 
the  severity  of  the  labor,  run  into  a  rupture  of  the 
genitalia.  In  some  even  the  vulva  and  anus  be- 
come one  foramen,  having  the  same  course.  As  a 
consequence,   prolapse   of  the  uterus   occurs,  and 


MEDIEVAL  WOMEN  PHYSICIANS  185 

it  becomes  indurated.  In  order  to  relieve  this  con- 
dition, we  apply  to  the  uterus  warm  wine  in  which 
butter  has  been  boiled,  and  these  fomentations  are 
continued  until  the  uterus  becomes  soft,  and  then  it 
is  gently  replaced.  After  this  the  tear  between  the 
anus  and  vulva  we  sew  in  three  or  four  places  with 
silk  thread.  The  woman  should  then  be  placed  in 
bed,  with  the  feet  elevated,  and  must  retain  that 
position,  even  for  eating  and  drinking,  and  all  the 
necessities  of  life,  for  eight  or  nine  days.  During 
this  time,  also,  there  must  be  no  bathing,  and  care 
must  be  taken  to  avoid  everything  that  might  cause 
coughing,  and  all  indigestible  materials.' ' 

There  is  a  passage,  also,  almost  more  interesting 
with  regard  to  prophylaxis  of  rupture  of  the 
perineum.  She  says,  "  In  order  to  avoid  the  afore- 
said danger,  careful  provision  should  be  made,  and 
precautions  should  be  taken  during  labor  somewhat 
as  follows:  A  cloth  should  be  folded  in  somewhat 
oblong  shape,  and  placed  on  the  anus,  so  that,  during 
every  effort  for  the  expulsion  of  the  child,  that 
should  be  pressed  firmly,  in  order  that  there  may 
not  be  any  solution  of  the  continuity  of  tissue." 

Her  book  contains,  also,  some  directions  for  vari- 
ous cosmetics.  How  many  of  these  are  original, 
however,  is  difficult  to  say.  Tro tula's  name  had  be- 
come a  word  to  conjure  with,  and  many  a  quack  in 
the  after  time  tried  to  make  capital  for  his  remedies 
in  this  line  by  attributing  them  to  Trotula.  As  a 
consequence,  many  of  these  remedies  gradually 
found  their  way  into  the  manuscript  copies  of  her 
book,  and  subsequent  copyists  incorporated  them 
into  the  text,  until  it  became  practically  impossible 


186  OLD-TIME  MAKERS  OF  MEDICINE 

to  determine  which  were  original.  There  are  manu- 
scripts of  Trotula's  work  in  Florence,  Vienna,  and 
Breslau.  Some  of  these  contain  chapters  not  in 
the  others,  undoubtedly  added  by  subsequent  hands. 
In  one  of  these,  that  at  Florence,  from  which  the  edi- 
tion of  Strasburg  was  printed  in  1544,  and  of  Venice, 
1547,  one  of  the  Aldine  issues,  there  is  a  mention  in 
the  last  chapter  of  spectacles.  We  have  no  record 
of  these  until  the  end  of  the  thirteenth  century, 
when  this  passage  was  probably  added.  It  was  also 
printed  at  Basle,  1566,  and  at  Leipzig  as  late  as 
1778,  which  would  serve  to  show  how  much  atten- 
tion it  has  attracted  even  in  comparatively  recent 
times. 

After  Trotula  we  have  a  number  of  women  physi- 
cians of  Salerno  whose  names  have  come  down  to  us. 
The  best  known  of  these  bear  the  names  Constanza, 
Calendula,  Abella,  Mercuriade,  Rebecca  Guarna,  who 
belonged  to  the  old  Salernitan  family  of  that  name, 
a  member  of  which,  in  the  twelfth  century,  was 
Romuald,  priest,  physician,  and  historian,  Louise 
Trencapilli,  and  others.  The  titles  of  some  of  their 
books,  as  those  of  Mercuriade,  who  occupied  her- 
self with  surgery  as  well  as  medicine,  and  who  is 
said  to  have  written  on  "  Crises,' '  on  "  Pestilent 
Fever, ' '  on  "  The  Cure  of  Wounds, ' '  and  of  Abella, 
who  acquired  a  great  reputation  with  her  work  on 
"  Black  Bile,"  and  on  the  "  Nature  of  Seminal 
Fluid,"  have  come  down  to  us.  Rebecca  Guarna 
wrote  on  "  Fevers,' '  on  the  "  Urine,"  and  on  the 
"  Embryo."  The  school  of  Salernitan  women 
came  to  have  a  definite  place  in  medical  literature. 

While,  as  teachers,  they  had  charge  of  the  depart- 


MEDIEVAL  WOMEN  PHYSICIANS  187 

ment  of  women's  diseases,  their  writings  wonld  seem 
to  indicate  that  they  studied  all  branches  of  medi- 
cine. Besides,  there  are  a  number  of  licenses  pre- 
served in  the  archives  of  Naples  in  which  women 
are  accorded  the  privilege  of  practising  medicine. 
Apparently  these  licenses  were  without  limitation. 
In  many  of  these  mention  is  made  of  the  fact  that 
it  seems  especially  fitting  that  women  should  be  al- 
lowed to  practise  in  women's  diseases,  since  they 
are  by  constitution  likely  to  know  more  and  to 
have  more  sympathy  with  feminine  ills.  The 
formula  employed  as  the  preamble  of  this  license 
ran  as  follows : ' '  Since,  then,  the  law  permits  women 
to  exercise  the  profession  of  physicians,  and  since, 
besides,  due  regard  being  had  to  purity  of  morals, 
women  are  better  suited  for  the  treatment  of 
women's  diseases,  after  having  received  the  oath  of 
fidelity,  we  permit,  etc." 

Salerno  continued  to  enjoy  a  reputation  for  train- 
ing women  physicians  thoroughly,  until  well  on  in 
the  fifteenth  century,  for  we  have  the  record  of  Con- 
stance Calenda,  the  daughter  of  Salvator  Calenda, 
who  had  been  dean  of  the  faculty  ojL  medicine,  at 
Salerno  about  1415,  and  afterwards  dean  of  the 
faculty  at  Naples.  His  daughter,  under  the  diligent 
instruction  of  her  father,  seems  to  have  obtained 
special  honors  for  her  medical  examination.  Not 
long  after  this,  Salerno  itself  lost  all  the  prestige 
that  it  had.  The  Kings  of  Naples  endeavored  to 
create  a  great  university  in  their  city  in  the  thir- 
teenth century.  They  did  not  succeed  to  the  extent 
that  they  hoped,  but  the  neighboring  rival  institution 
hurt  Salerno  very  much,  and  its  downfall  may  be 


188  OLD-TIME  MAKERS  OF  MEDICINE 

traced  from  this  time.  Gradually  its  reputation 
waned,  and  we  have  practically  no  medical  writer  of 
distinction  there  at  the  end  of  the  fourteenth  cen- 
tury, though  the  old  custom  of  opportunities  for 
women  students  of  medicine  was  maintained. 

This  custom  seems  also  to  have  been  transferred 
to  Naples,  and  licenses  to  practise  were  issued  to 
woman  graduates  of  Naples.  This  never  achieved 
anything  like  the  reputation  in  this  department  that 
had  been  attained  at  Salerno.  Salerno  influenced 
Bologna  and  the  north  Italian  universities  pro- 
foundly in  all  branches  of  medicine  and  medical  edu- 
cation, particularly  in  surgery,  as  can  be  seen  in 
the  chapter  on  "  Great  Surgeons  of  the  Medieval 
Universities, ' '  and  the  practice  of  allowing  such 
women  as  wished  to  study  medicine  to  enter  the 
university  medical  schools  is  exemplified  in  the  case 
of  Mondino's  assistant  in  anatomy,  Alessandra 
Giliani,  though  there  are  also  others  whose  names 
have  come  down  to  us. 

The  University  of  Salerno  had  developed  round 
a  medical  school.  It  was  the  first  of  the  uni- 
versities, and,  in  connection  with  its  medical  school, 
feminine  education  obtained  a  strong  foothold.  It 
is  not  surprising,  then,  that  with  the  further  de- 
velopment of  universities  in  Italy,  feminine  educa- 
tion came  to  be  the  rule.  This  rule  has  maintained 
itself  all  down  the  centuries  in  Italy,  so  that  there 
has  not  been  a  single  century  since  the  twelfth  in 
which  there  have  not  been  one  or  more  distinguished 
women  teachers  at  the  Italian  universities.  Uni- 
versity life  gradually  spread  westward,  and  Paris 
came  into  existence  as  an  organized  institution  of 


MEDIEVAL  WOMEN  PHYSICIANS  189 

learning  after  Bologna,  and,  doubtless,  with  some 
of  the  traditions  of  Salerno  in  the  minds  of  its 
founders.  Feminine  education,  however,  did  not 
spread  to  the  West.  This  is  a  little  bit  difficult  to 
understand,  considering  the  reverence  that  the  Teu- 
tonic peoples  have  always  had  for  their  women  folk 
and  the  privileges  accorded  them.  A  single  un- 
fortunate incident,  that  of  Abelard  and  Heloise, 
seems  to  have  been  sufficient  to  discourage  efforts 
in  the  direction  of  opportunities  for  feminine  edu- 
cation in  connection  with  the  Western  universities. 
Perhaps,  in  the  less  sophisticated  countries  of  the 
North  and  West  of  Europe,  women  did  not  so 
ardently  desire  educational  opportunities  as  in  Italy, 
for  whenever  they  have  really  wanted  them,  as, 
indeed,  anything  else,  they  have  always  obtained 
them. 

In  spite  of  the  absence  of  formal  opportunities 
for  feminine  education  in  medicine  at  the  Western 
universities,  a  certain  amount  of  scientific  knowl- 
edge of  diseases,  as  well  as  valuable  practical  train- 
ing in  the  care  of  the  ailing,  was  not  wanting  for 
women  outside  of  Italy.  The  medical  knowledge  of 
the  women  of  northern  France  and  Germany  and 
England,  however,  though  it  did  not  receive  the 
stamp  of  a  formal  degree  from  the  university  and 
the  distinction  of  a  license  to  practise,  was  none  the 
less  thorough  and  extensive.  It  came  in  connection 
with  certain  offices  in  their  own  communities,  held 
by  members  of  religious  orders.  Genuine  informa- 
tion with  regard  to  what  the  religious  were  doing 
during  the  Middle  Ages  was  so  much  obscured  by 
the  tradition  of  laziness  and  immorality,  created  at 


190  OLD-TIME  MAKERS  OF  MEDICINE 

the  time  of  the  so-called  reformation  in  order  to 
justify  the  confiscation  of  their  property  by  those 
whose  one  object  was  to  enrich  themselves,  that  we 
have  only  come  to  know  the  reality  of  their  life  and 
accomplishments  in  comparatively  recent  years. 
We  now  know  that,  besides  being  the  home  of  most 
of  the  book  knowledge  of  the  earlier  Middle  Ages, 
the  monasteries  were  the  constant  patrons  of  such 
practical  subjects  as  architecture,  agriculture  in  all 
its  phases,  especially  irrigation,  draining,  and  the 
improvement  of  land  and  crops;  of  art,  and  even 
what  we  now  know  as  physical  science.  Above  all, 
they  preserved  for  us  the  old  medical  books  and 
carried  on  medical  traditions  of  practice.  The 
greatest  surprise  has  been  to  find  that  this  was 
true  not  only  for  the  monks,  but  also  for  the 
nuns. 

One  of  the  most  important  books  on  medicine  that 
has  come  to  us  from  the  twelfth  century  is  that  of  a 
Benedictine  abbess,  since  known  as  St.  Hildegarde, 
whose  life  was  spent  in  the  Ehineland.  Her  works 
serve  to  show  very  well  that  in  the  convents  of  the 
tenth,  eleventh,  and  twelfth  centuries  there  was 
much  more  of  interest  in  things  intellectual  than  we 
have  had  any  idea  of  until  recent  years,  and  that, 
indeed,  one  of  the  important  occupations  of  convent 
life  was  the  serious  study  of  books  of  all  kinds,  some 
of  them  even  scientific,  as  well  as  the  writing  of 
works  in  all  departments.  The  century  before  St. 
Hildegarde  there  is  the  record  of  Hroswitha,  who 
wrote  a  series  of  dramas  in  imitation  of  Terence, 
that  were  meant  to  replace,  for  the  monks  and  nuns 
of  that  period,  the  reading  of  that  rather  too  human 


MEDIEVAL  WOMEN  PHYSICIANS  191 

author.  Hroswitha,  like  Hildegarde,  was  a  German, 
and  we  have  the  record,  also,  of  another  religions 
writer,  abbess  of  the  Odilian  Cloister,  at  Hohenberg, 
who  wrote  a  book  called  "  Hortns  Deliciarnm,  the 
Garden  of  Delights/ '  a  book  of  information  on 
many  subjects  not  unlike  our  popular  encyclopedias 
of  the  modern  time,  the  title  of  which  shows  that 
the  place  of  information  in  life  was  considered  to  be 
the  giving  of  pleasure.  While  this  work  deals 
mainly  with  Biblical  and  theological  and  mystical 
questions,  there  are  many  purely  scientific  passages 
and  many  subjects  of  strictly  medical  interest 
treated. 

The  life  of  the  Abbess  Hildegarde  is  worthy  of 
consideration,  because  it  illustrates  the  period  and 
makes  it  very  clear  that,  in  spite  of  the  grievous 
misunderstanding  of  their  life  and  work,  so  com- 
mon in  the  modern  time,  these  old-time  religious 
had  most  of  the  interests  of  the  modern  time,  and 
pursued  them  with  even  more  than  modern  zeal 
and  success,  very  often.  Her  career  illustrates 
very  well  what  the  foundation  of  the  Benedictines 
had  done  for  women.  When  St.  Benedict  founded 
his  order  for  men,  his  sister,  Scholastica,  wanted 
to  do  a  similar  work  for  women.  We  know  that 
the  Benedictine  monks  saved  the  old  classics  for 
us,  kept  burning  the  light  of  the  intellectual  life, 
and  gave  a  refuge  to  men  who  wanted  to  devote 
themselves  in  leisure  and  peace  to  the  things  of 
the  spirit,  whether  of  this  world  or  the  other.  We 
have  known  much  less  of  the  Benedictine  nuns  un- 
til now  the  study  of  their  books  shows  that  they 
provided  exactly  the  same  opportunities  for  women 


192  OLD-TIME  MAKERS  OF  MEDICINE 

and  furnished  a  vocation,  a  home,  an  occupation  of 
mind,  and  a  satisfaction  of  spirit  for  the  women 
who,  in  every  generation,  do  not  feel  themselves 
called  to  be  wives  and  mothers,  but  who  want  to 
live  their  lives  for  others  rather  than  for  them- 
selves and  their  kin,  seeking  such  development  of 
mind  and  of  spirit  as  may  come  with  the  leisure  and 
peace  of  celibacy. 

Hildegarde  was  born  of  noble  parents  at  Bockel- 
heim,  in  the  county  of  Sponheim,  about  the  end  of 
the  eleventh  century  (probably  1098).  In  her  eighth 
year  she  went  for  her  education  to  the  Benedictine 
cloister  of  Disibodenberg.  When  her  education  was 
finished,  she  entered  the  cloister,  of  which,  at  the  age 
of  about  fifty,  she  became  abbess.  Her  writings, 
reputation  for  sanctity,  and  her  wise  saintly  rule 
attracted  so  many  new  members  to  the  community 
that  the  convent  became  overcrowded.  Accord- 
ingly, with  eighteen  of  her  nuns,  Hildegarde  with- 
drew to  a  new  convent  at  Eupertsberg,  which  Eng- 
lish and  American  travellers  will  remember  because 
it  is  not  far  from  Bingen  on  the  Ehine.  Here  she 
came  to  be  a  centre  of  attraction  for  most  of  the 
world  of  her  time.  She  was  in  active  correspond- 
ence with  nearly  every  important  man  of  her  gen- 
eration. She  was  an  intimate  friend  of  Bernard  of 
Clairvaux,  who  was  himself,  perhaps,  the  most  in- 
fluential man  in  Europe  in  this  century.  She  was  in 
correspondence  with  four  Popes,  and  with  the  Em- 
perors Conrad  and  Frederick  I,  and  with  many  dis- 
tinguished archbishops,  abbots,  and  abbesses,  and 
teachers  and  teaching  bodies  of  various  kinds.  These 
correspondences  were  usually  begun  by  her  corre- 


MEDIEVAL  WOMEN  PHYSICIANS  193 

spondents,  who  consulted  her  because  her  advice 
in  difficult  problems  was  considered  so  valu- 
able. 

In  spite  of  all  this  time-taking  correspondence, 
she  found  leisure  to  write  a  series  of  books,  most 
of  them  on  mystical  subjects,  but  two  of  them  on 
medical  subjects.  The  first  is  called  "  Liber  Sim- 
plicis  Medicinas,"  and  the  second  "  Liber  Composite 
Medicinal"  These  books  were  written  in  order  to 
provide  information  mainly  for  the  nuns  who  had 
charge  of  the  infirmaries  of  the  monasteries  of  the 
Benedictines.  Almost  constantly  someone  in  the 
large  communities,  which  always  contained  aged  re- 
ligious, was  ailing,  and  then,  besides,  there  were 
other  calls  on  the  time  and  the  skill  of  the  sister 
infirmarians.  There  were  no  hotels  at  that  time, 
and  no  hospitals,  except  in  the  large  cities.  There 
were  always  guest  houses  in  connection  with 
monasteries  and  convents,  in  which  travellers  were 
permitted  to  pass  the  night,  and  given  what  they 
needed  to  eat.  There  are  many  people  who  have 
had  experiences  of  monastic  hospitality  even  in  our 
own  time.  Sometimes  travellers  fell  ill.  Not  in- 
frequently the  reason  for  travelling  was  to  find 
health  in  some  distant  and  fabulously  health-giving 
resort,  or  at  the  hands  of  some  wonder-working 
physician.  Such  high  hopes  are  nearly  always  set 
at  a  distance.  This  of  itself  must  have  given  not 
a  little  additional  need  for  knowledge  of  medicine 
to  the  infirmarians  of  convents  and  monasteries. 
There  were  around  many  of  the  monasteries,  more- 
over, large  estates ;  often  they  had  been  cleared  and 
made  valuable  by  the  work  of  preceding  genera- 


194  OLD-TIME  MAKERS  OF  MEDICINE 

tions  of  monks,  and  on  these  estates  peasants  came 
to  live.  Workingmen  and  workingwomen  from 
neighboring  districts  came  to  help  at  harvest  time, 
and,  after  a  chance  meeting,  were  married  and 
settled  down  on  a  little  plot  of  ground  provided 
for  them  near  the  monastery.  As  these  communi- 
ties grew  up,  they  looked  to  the  monasteries  and 
convents  for  aid  of  all  kinds,  and  turned  to  them 
particularly  in  times  of  illness.  The  need  for 
definite  instruction  in  medicine  on  the  part  of  a 
great  many  of  the  monks  and  nuns  can  be  readily 
understood,  and  it  was  this  need  that  Hildegarde 
tried  to  meet  in  her  books.  The  first  of  her  books 
that  we  have  mentioned,  the  "  Liber  Simplicis 
Medicinae,"  attracted  attention  rather  early  in  the 
Eenaissance,  and  was  deemed  worthy  of  print.  It 
was  edited  at  the  beginning  of  the  sixteenth  century 
by  Dr.  Schott  at  Strasburg,  under  the  title, 
"  Physica  S.  Hildegardis. ' '  Another  manuscript 
of  this  part  was  found  in  the  library  of  Wolfenbut- 
tel,  in  1858,  by  Dr.  Jessen.  This  gave  him  an  in- 
terest in  Hildegarde 's  contributions  to  medicine, 
and,  in  1859,  he  noted  in  the  library  at  Copenhagen 
a  manuscript  with  the  title  "  Hildegardi  Curae  et 
Causae."  On  examination,  he  was  sure  that  it  was 
the  "  Liber  Composite  Medicinae  "  of  the  saint. 
The  first  work  consists  of  nine  books,  treating  of 
plants,  elements,  trees,  stones,  fishes,  birds, 
quadrupeds,  reptiles,  and  metals,  and  is  printed  in 
Migne's  "  Patrologia,"  under  the  title  "  Subtilita- 
tum  Diversarum  Naturarum  Libri  Novem."  The 
second,  in  five  books,  treats  of  the  general  diseases 
of  created  things,  of  the  human  body  and  its  ail- 


MEDIEVAL  WOMEN  PHYSICIANS  195 

ments,  of  the  causes,  symptoms,  and  treatment  of 
diseases. 

It  would  be  very  easy  to  think  that  these  are  small 
volumes  and  that  they  contain  very  little.  We  are 
so  apt  to  think  of  old-fashioned  so-called  books  as 
scarcely  more  than  chapters,  that  it  may  be  interest- 
ing to  give  some  idea  of  the  contents  and  extent  of 
the  first  of  these  works.  The  first  book  on  Plants 
has  230  chapters,  the  second  on  the  Elements  has 
13  chapters,  the  third  on  Trees  has  36  chapters,  the 
fourth  on  various  kinds  of  Minerals,  including  pre- 
cious stones,  has  228  chapters,  the  fifth  on  Fishes 
has  36  chapters,  the  sixth  on  Birds  has  68  chapters, 
the  seventh  on  Quadrupeds  has  43  chapters,  the 
eighth  on  Reptiles  has  18  chapters,  the  ninth  on 
Metals  has  8  chapters.  Each  chapter  begins  with 
a  description  of  the  species  in  question,  and  then 
defines  its  value  for  man  and  its  therapeutic  sig- 
nificance. Modern  scientists  have  not  hesitated  to 
declare  that  the  descriptions  abound  in  observa- 
tions worthy  of  a  scientific  inquiring  spirit.  We 
are,  of  course,  not  absolutely  sure  that  all  the  con- 
tents of  the  books  come  from  Hildegarde.  Subse- 
quent students  often  made  notes  in  these  manuscript 
books,  and  then  other  copyists  copied  these  into 
the  texts.  Unfortunately  we  have  not  a  number  of 
codices  to  collate  and  correct  such  errors.  Most 
of  what  Hildegarde  wrote  comes  to  us  in  a  single 
copy,  of  none  are  there  more  than  four  copies,  show- 
ing how  near  we  came  to  missing  all  knowledge  of 
her  entirely. 

Dr.  Melanie  Lipinska,  in  her  "  Histoire  des 
Femmes  Medeaus,"  a  thesis  presented  for  the  doc- 


196  OLD-TIME  MAKERS  OF  MEDICINE 

torate  in  medicine  at  the  University  of  Paris  in 
1900,  subsequently  awarded  a  special  prize  by  the 
French  Academy,  reviews  Hildegarde's  work 
critically  from  the  medical  standpoint.  She  says 
that  the  saint  distinguishes  a  double  mode  of  action 
of  different  substances,  one  chemical,  the  other  phys- 
ical, or  what  we  would  very  probably  call  magnetic. 
She  discusses  all  the  ailments  of  the  various  organs, 
the  brain,  the  eyes,  the  teeth,  the  heart,  the  spleen, 
the  stomach,  the  liver.  She  has  special  chapters  on 
redness  and  paleness  of  the  face,  on  asthma,  on 
cough,  on  fetid  breath,  on  bilious  indigestion,  on 
gout.  Besides,  she  has  other  chapters  on  nervous 
affections,  on  icterus,  on  fevers,  on  intestinal  worms, 
on  infections  due  to  swamp  exhalations,  on  dysen- 
tery, and  a  number  of  forms  of  pulmonary  diseases. 
Nearly  all  of  our  methods  of  diagnosis  are  to  be 
found,  hinted  at  at  least,  in  her  book.  She  dis- 
cusses the  redness  of  the  blood  as  a  sign  of  health, 
the  characteristics  of  various  excrementitious  mate- 
rial as  signs  of  disease,  the  degrees  of  fever, 
and  the  changes  in  the  pulse.  Of  course,  it  was 
changes  in  the  humors  of  the  body  that  constituted 
the  main  causes  for  disease  in  her  opinion,  but  it  is 
well  to  remind  ourselves  that  our  frequent  dis- 
cussion of  auto-intoxication  in  recent  years  is  a  dis- 
tinct return  to  this. 

Some  of  Hildegarde's  anticipations  of  modern 
ideas  are,  indeed,  surprising  enough.  For  instance, 
in  talking  about  the  stars  and  describing  their 
course  through  the  firmament,  she  makes  use  of  a 
comparison  that  is  rather  startling.  She  says: 
"  Just  as  the  blood  moves  in  the  veins  which  causes 


MEDIEVAL  WOMEN  PHYSICIANS  197 

them  to  vibrate  and  pulsate,  so  the  stars  move  in 
the  firmament  and  send  out  sparks  as  it  were  of 
light  like  the  vibrations  of  the  veins.' '  This  is,  of 
course,  not  an  anticipation  of  the  discovery  of  the 
circulation  of  the  blood,  but  it  shows  how  close  were 
men's  ideas  to  some  such  thought  five  centuries  be- 
fore Harvey's  discovery.  For  Hildegarde  the  brain 
was  the  regulator  of  all  the  vital  qualities,  the  centre 
of  life.  She  connects  the  nerves  in  their  passage 
from  the  brain  and  the  spinal  cord  through  the  body 
with  manifestations  of  life.  She  has  a  series  of 
chapters  with  regard  to  psychology  normal  and 
morbid.  She  talks  about  frenzy,  insanity,  despair, 
dread,  obsession,  anger,  idiocy,  and  innocency. 
She  says  very  strongly  in  one  place  that  "  when 
headache  and  migraine  and  vertigo  attack  a  patient 
simultaneously  they  render  a  man  foolish  and  up- 
set his  reason.  This  makes  many  people  think  that 
he  is  possessed  of  a  demon,  but  that  is  not  true." 
These  are  the  exact  words  of  the  saint  as  quoted  in 
Mile.  Lipinska's  thesis. 

It  is  no  wonder  that  Mile.  Lipinska  thinks  St. 
Hildegarde  the  most  important  medical  writer  of  her 
time.  Eeuss,  the  editor  of  the  edition  of  Hilde- 
garde published  in  Migne's  "  Patrology,"  says: 
"  Among  all  the  saintly  religious  who  have  prac- 
tised medicine  or  written  about  it  in  the  Middle 
Ages,  the  most  important  is  without  any  doubt  St. 
Hildegarde.  .  .  . "  With  regard  to  her  book  he 
says :  ' '  All  those  who  wish  to  write  the  history  of 
the  medical  and  natural  sciences  must  read  this  work 
in  which  this  religious  woman,  evidently  well 
grounded  in  all  that  was  known  at  that  time  in  the 


198  OLD-TIME  MAKERS  OF  MEDICINE 

secrets  of  nature,  discusses  and  examines  carefully 
all  the  knowledge  of  the  time."  He  adds,  "  It  is 
certain  that  St.  Hildegarde  knew  many  things  that 
were  unknown  to  the  physicians  of  her  time. ' ' 

When  such  books  were  read  and  widely  copied,  it 
shows  that  there  was  an  interest  in  practical  and 
scientific  medicine  among  women  in  Germany  much 
greater  than  is  usually  thought  to  have  existed  at 
this  time.  Such  writers,  though  geniuses,  and 
standing  above  their  contemporaries,  usually  repre- 
sent the  spirit  of  their  times  and  make  it  clear  that 
definite  knowledge  of  things  medical  was  consid- 
ered of  value.  The  convents  and  monasteries  of 
this  time  are  often  thought  of  by  those  who  know 
least  about  them  as  little  interested  in  anything 
except  their  own  ease  and  certain  superstitious  prac- 
tices. As  a  matter  of  fact,  they  cared  for  their 
estates,  and  especially  for  the  peasantry  on  them, 
they  provided  lodging  and  food  for  travellers,  they 
took  care  of  the  ailing  of  their  neighborhood,  and, 
besides,  occupied  themselves  with  many  phases  of 
the  intellectual  life.  It  was  a  well-known  tradition 
that  country  people  who  lived  in  the  neighborhood  of 
convents  and  monasteries,  and  especially  those  who 
had  monks  and  nuns  for  their  landlords,  were  much 
happier  and  were  much  better  taken  care  of  than 
the  tenantry  of  other  estates.  For  this  a  cultiva- 
tion of  medical  knowledge  was  necessary  in  certain, 
at  least,  of  the  members  of  the  religious  orders,  and 
such  books  as  Hildegarde's  are  the  evidence  that 
not  only  the  knowledge  existed,  but  that  it  was  col- 
lected and  written  down,  and  widely  disseminated. 

Nicaise,   in   the   introduction   to   his   edition   of 


MEDIEVAL  WOMEN  PHYSICIANS  199 

Guy  de  Chauliac's  "  Grande  Chirurgie,"  reviews 
briefly  the  history  of  women  in  medicine,  and  con- 
cludes : 

"  Women  continued  to  practise  medicine  in  Italy 
for  centuries,  and  the  names  of  some  who  attained 
great  renown  have  been  preserved  for  us.  Their 
works  are  still  quoted  from  in  the  fifteenth  century. 

"  There  was  none  of  them  in  France  who  became 
distinguished,  but  women  could  practise  medicine  in 
certain  towns  at  least  on  condition  of  passing  an 
examination  before  regularly  appointed  masters. 
An  edict  of  1311,  at  the  same  time  that  it  interdicts 
unauthorized  women  from  practising  surgery,  recog- 
nizes their  right  to  practise  the  art  if  they  have 
undergone  an  examination  before  the  regularly  ap- 
pointed master  surgeons  of  the  corporation  of  Paris. 
An  edict  of  King  John,  April,  1352,  contains  the 
same  expressions  as  the  previous  edict.  Du  Bouley, 
in  his  '  History  of  the  University  of  Paris, '  gives 
another  edict  by  the  same  King,  also  published  in 
the  year  1352,  as  a  result  of  the  complaints  of  the 
faculties  at  Paris,  in  which  there  is  also  question 
of  women  physicians.  This  responded  to  the  peti- 
tion :  '  Having  heard  the  petition  of  the  Dean  and 
the  Masters  of  the  Faculty  of  Medicine  at  the  Uni- 
versity of  Paris,  who  declare  that  there  are  very 
many  of  both  sexes,  some  of  the  women  with  legal 
title  to  practise  and  some  of  them  merely  old  pre- 
tenders to  a  knowledge  of  medicine,  who  come  to 
Paris  in  order  to  practise,  be  it  enacted/  etc.  (The 
edict  then  proceeds  to  repeat  the  terms  of  previous 
legislation  in  this  matter.) 

"  Guy  de  Chauliac  speaks  also  of  women  who 
practised  surgery.  They  formed  the  fifth  and  last 
class  of  operators  in  his  time.  He  complains  that 
they  are  accustomed  to  too  great  an  extent  to  give 
over  patients  suffering  from  all  kinds  of  maladies 


200  OLD-TIME  MAKERS  OF  MEDICINE 

to  the  will  of  Heaven,  founding  their  practice  on 
the  maxim  '  The  Lord  has  given  as  he  has  pleased; 
the  Lord  will  take  away  when  he  pleases;  may  the 
name  of  the  Lord  be  blessed.' 

"  In  the  sixteenth  century,  according  to  Pasquier, 
the  practice  of  medicine  by  women  almost  entirely 
disappeared.  The  number  of  women  physicians  be- 
comes more  and  more  rare  in  the  following  centuries 
just  in  proportion  as  we  approach  our  own  time. 
Pasquier  says  that  we  find  a  certain  number  of  them 
anxious  for  knowledge  and  with  a  special  penchant 
for  the  study  of  the  natural  sciences  and  even  of 
medicine,  but  very  few  of  them  take  up  practice. ' ' 

Just  how  the  lack  of  interest  in  medical  education 
for  women  gradually  deepened,  until  there  was  al- 
most a  negative  phase  of  it,  only  a  few  women  in 
Italy  devoting  themselves  to  medicine,  is  hard  to 
say.  It  is  one  of  the  mysteries  of  the  vicissitudes 
of  human  affairs  that  ups  and  downs  of  interest  in 
things  practical  as  well  as  intellectual  keep  con- 
stantly occurring.  The  number  of  discoveries  and 
inventions  in  medicine  and  surgery  that  we  have 
neglected  until  they  were  forgotten,  and  then  had 
to  make  again,  is  so  well  illustrated  in  chapters  of 
this  book,  that  I  need  only  recall  them  here  in  gen- 
eral. It  may  seem  a  little  harder  to  understand 
that  so  important  a  manifestation  of  interest  in 
human  affairs  as  the  education  and  licensure  of 
women  physicians  should  not  only  cease,  but  pass 
entirely  out  of  men's  memory,  yet  such  apparently 
was  the  case.  It  would  not  be  hard  to  illustrate,  as 
I  have  shown  in  "  Cycles  of  Feminine  Education 
and  Influence  ' '  in  "  Education,  How  Old  the  New  ' f 
(Fordham    University   Press,    1910),    that    corre- 


MEDIEVAL  WOMEN  PHYSICIANS  201 

sponding  ups  and  downs  of  interest  may  be  traced  in 
the  history  of  feminine  education  of  every  kind. 
In  that  chapter  I  have  discussed  the  possible  rea- 
sons for  these  vicissitudes,  which  have  no  place  here, 
but  I  may  refer  those  who  are  interested  in  the 
subject  to  that  treatment  of  it. 


IX 


MONDINO  AND  THE  MEDICAL  SCHOOL  OF 

BOLOGNA 

The  most  important  contributions  to  medical  sci- 
ence made  by  the  Medical  School  of  Salerno  at  the 
height  of  its  development  were  in  surgery.    The 
text-books  written  by  men  trained  in  her  halls  or 
inspired  by  her  teachers  were  to  influence  many 
succeeding  generations  of  surgeons  for  centuries. 
Salerno's  greatest  legacy  to  Bologna  was  the  group 
of  distinguished  surgical  teachers  whose  text-books 
we  have  reviewed  in  the  chapter,  "  Great  Surgeons 
of  the  Medieval  Universities.' '    Bologna  herself  was 
to  win  a  place  in  medical  history,  however,  mainly  in 
connection  with  anatomy,  and  it  was  in  this  depart- 
ment that  she  was  to  provide  incentive  especially 
for  her  sister  universities  of  north  Italy,  though 
also    for    "Western    Europe    generally.    The    first 
manual  of  dissection,  that  is,  the  first  handy  volume 
giving  explicit  directions  for  the  dissection  of  human 
cadavers,  was  written  at  Bologna.    This  was  scat- 
tered in  thousands  of  copies  in  manuscript  all  over 
the  medical  world  of  the  fourteenth  and  early  fif- 
teenth centuries.    Even  after  the  invention  of  print- 
ing, many  editions  of  it  were  printed.    Down  to  the 
sixteenth  century  it  continued  to  be  the  most  used 
text-book  of  anatomy,  as  well  as  manual  of  dissec- 
tion, which  students  of  every  university  had  in  hand 

202 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA    203 

when  they  made  their  dissection,  or  wished  to  pre- 
pare for  making  it,  or  desired  to  review  it  after  the 
body  had  been  taken  away,  for  with  lack  of  proper 
preservative  preparation,  bodies  had  to  be  removed 
in  a  comparatively  short  time.  Probably  no  man 
more  influenced  the  medical  teaching  of  the  four- 
teenth and  fifteen  centuries  than  Mundinus,  or,  as 
he  was  called  in  the  Italian  fashion,  Mondino,  who 
wrote  this  manual  of  dissection. 

Mundinus  quern  omnis  studentium  universitas 
colit  ut  deum  (Mundinus,  whom  all  the  world  of  stu- 
dents cultivated  as  a  god),  is  the  expression  by 
which  the  German  scholar  who  edited,  about  1500, 
the  Leipzig  edition  of  Mundinus'  well-known 
manual,  the  Anathomia,  introduces  it  to  his  readers. 
The  expression  is  well  worth  noting,  because  it 
shows  what  was  still  the  reputation  of  Mundinus  in 
the  medical  educational  world  nearly  two  centuries 
after  his  death.1 

Until  the  time  of  Vesalius,  whose  influence  was 
exerted  about  the  middle  of  the  sixteenth  century, 
Mondino  was  looked  up  to  by  all  teachers  as 
the  most  important  contributor  to  the  science  of 

1  It  is  probably  interesting  to  note  that  the  word  universitas  as  used 
here  has  no  reference  to  our  word  university,  but  refers  to  the  whole 
world  of  students  as  it  were.  In  the  Middle  Ages  universities  were 
called  studia  generalia,  general  studies — that  is,  places  where  everything 
could  be  studied  and  where  everyone  from  any  part  of  the  world  could 
study.  Our  use  of  the  word  university  in  the  special  modern  sense 
of  the  term  comes  from  the  formal  mode  of  address  to  the  faculty  of  a 
university  when  Popes  or  rulers  sent  them  authoritative  documents. 
Such  documents  began  with  the  expression  Universitas  vestra,  all  of 
you  (in  the  old-time  English,  as  preserved  in  the  Irish  expression,  "  the 
whole  of  ye"),  referring  to  all  the  members  of  the  faculty.  The  transfer 
to  our  term  and  signification  university  was  not  difficult. 


204  OLD-TIME  MAKERS  OF  MEDICINE 

anatomy  in  European  medicine  since  the  Greeks. 
He  owed  his  reputation  to  two  things :  his  book,  of 
which  we  have  already  spoken,  and  then,  the  fact 
that  he  reintroduced  dissection  demonstrations  as 
a  regular  practice  in  the  medical  schools.  His  book 
is  really  a  manual  of  making  anatomical  prepara- 
tions for  demonstration  purposes.  These  demon- 
strations had  to  be  hurried,  owing  to  the  rapid  de- 
composition of  material  consequent  upon  the  lack 
of  preservatives.  The  various  chapters  were  pre- 
pared with  the  idea  of  supplying  explicit  directions 
and  practical  help  during  the  anatomical  demonstra- 
tions, so  that  these  might  be  made  as  speedily  as 
possible.  The  book  does  not  comprise  much  that 
was  new  at  that  time,  but  it  is  a  good  compendium  of 
previous  knowledge,  and  contains  some  original  ob- 
servations. It  was  entirely  owing  to  its  form  as  a 
handy  manual  of  anatomical  knowledge  and,  besides, 
because  it  was  an  incentive  to  the  practice  of  human 
dissection,  that  it  attained  and  maintained  its  pop- 
ularity. 

Mondino  followed  Galen,  of  course,  and  so  did 
every  other  teacher  in  medicine  and  its  allied  sci- 
ences, until  Vesalius'  time.  Even  Vesalius  permit- 
ted himself  to  be  influenced  overmuch  by  Galen  at 
points  where  we  wonder  that  he  did  not  make  his 
observations  for  himself,  since,  apparently,  they 
were  so  obvious.  The  more  we  know  of  Galen, 
however,  the  less  surprised  are  we  at  his  hold  over 
the  minds  of  men.  Only  those  who  are  ignorant  of 
Galen's  immense  knowledge,  his  practical  common 
sense,  and  the  frequent  marvellous  anticipations  of 
what  we  think  most  modern,  affect  to  despise  him. 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     205 

His  works  have  never  been  translated  into  any 
modern  language  except  piecemeal,  there  is  no  com- 
plete translation,  and  one  must  be  ready  to  delve 
into  some  large  Latin,  if  not  Greek,  volumes  to 
know  what  a  marvel  of  medical  knowledge  he  was, 
and  how  wise  were  the  men  who  followed  him 
closely,  though,  being  human,  there  are  times  when 
necessarily  he  failed  them. 

For  those  who  know  even  a  little  at  first  hand  of 
Galen,  it  is  only  what  might  be  expected,  then,  that 
Mondino,  trying  to  break  away  from  the  anatomy 
of  the  pig,  which  had  been  before  this  the  basis  of  all 
anatomical  teaching  in  the  medical  schools  (Copho's 
book,  used  at  Salerno  and  Bologna  before  Mondino 's 
was  founded  on  dissections  of  the  pig),  should  have 
clung  somewhat  too  closely  to  this  old  Greek  teacher 
and  Greek  master.  The  incentive  furnished  by 
Mondino 's  book  helped  to  break  the  tradition  of 
Galen's  unquestioned  authority.  Besides  this,  the 
group  of  men  around  Mondino,  his  master,  Taddeo 
Alderotti,  with  his  disciples  and  assistants,  form 
the  initial  chapter  in  the  history  of  the  medical 
school  of  Bologna,  which  gradually  assumed  the 
place  of  Salerno  at  this  time.  There  is  no  better 
way  of  getting  a  definite  idea  of  what  was  being  done 
in  medicine,  and  how  it  was  being  done,  than  by 
knowing  some  of  the  details  of  the  life  of  this 
group  of  medical  workers. 

Mondino  di  Liucci,  or  Luzzi,  is  usually  said  to 
have  been  born  about  1275.  His  first  name  is  a 
diminutive  for  Eaimondo.  It  used  to  be  said  of 
him  that,  like  many  of  the  great  men  of  history, 
many  cities  claimed  to  be  his  birthplace.    Five  were 


206  OLD-TIME  MAKERS  OF  MEDICINE 

particularly  mentioned — Florence,  Milan,  Bologna, 
Forli,  and  Friuli.  There  is,  however,  another  Mon- 
dino,  a  distinguished  physician,  who  was  born  and 
lived  at  Friuli,  and  it  is  because  of  confusion  with 
him  that  the  claim  for  Friuli  has  been  set  up. 
Florence  and  Milan  are  considered  out  of  the  ques- 
tion. Mondino  was  probably  born  in  or  near  Bo- 
logna. The  fact  that  there  should  have  been  this 
multiple  set  of  claims  shows  how  much  was  thought 
of  him.  Indeed,  his  was  the  best  known  name  in  the 
medical  schools  of  Europe  for  nearly  two  centuries 
and  a  half.  He  seems  to  have  been  a  particularly 
brilliant  student,  for  tradition  records  that  he  had 
obtained  his  degree  of  doctor  of  medicine  when  he 
was  scarcely  more  than  twenty.  This  seems  quite 
out  of  the  question  for  us  at  the  present  time,  but 
we  have  taken  to  pushing  back  the  time  of  gradua- 
tion, and  it  is  not  sure  whether  this  is,  beyond 
peradventure,  so  beneficial  as  is  usually  thought. 

That  his  early  graduation  did  not  hamper  his  in- 
tellectual development,  the  fact  that,  in  1306,  when 
he  was  about  thirty-one  years  of  age,  he  was  offered 
the  professorial  chair  in  anatomy,  which  he  con- 
tinued to  occupy  with  such  distinction  for  the  next 
twenty  years,  would  seem  to  prove.  His  public  dis- 
sections of  human  bodies,  probably  the  first  thus 
regularly  made,  attracted  widespread  attention,  and 
students  came  to  him  not  only  from  all  over  Italy, 
but  also  from  Europe  generally.  In  this,  after  all, 
Mondino  was  only  continuing  the  tradition  of  world 
teaching  that  Bologna  had  acquired  under  her  great 
surgeons  in  the  preceding  century.  (See  "  Great 
Surgeons  of  the  Medieval  Universities.") 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     207 

Mondino  came  from  a  family  that  had  already  dis- 
tinguished itself  in  medicine  at  Bologna.  His  uncle 
was  a  professor  of  physic  at  the  university.  His 
father,  Albizzo  di  Luzzi,  seems  to  have  come  from 
Florence  not  long  after  the  middle  of  the  thirteenth 
century,  for  the  records  show  that,  about  1270,  he 
formed  a  partnership  with  one  Bartolommeo  Eaineri 
for  the  establishment  of  a  pharmacy  at  Bologna. 
Later  this  passed  entirely  under  the  control  of  the 
Mondino  family,  and  came  to  be  known  as  the 
Spezieria  del  Mondino.  In  it  were  sold,  besides 
Eastern  perfumes,  spices,  condiments,  probably  all 
sorts  of  toilet  articles,  and  even  rugs  and  silks  and 
feminine  ornaments.  The  stricter  pharmacy  of  the 
earlier  times  developed  into  a  sort  of  department 
store,  something  like  our  own.  The  Mondini,  how- 
ever, insisted  always  on  the  pharmacy  feature  as  a 
specialty,  and  the  fact  was  made  patent  to  the  gen- 
eral public  by  a  sign  with  the  picture  of  a  doctor  on 
it.  This  drug  shop  of  the  Mondini  continued  to  be 
maintained  as  such,  according  to  Dr.  Pilcher,  until 
the  beginning  of  the  nineteenth  century.1 

One  of  the  fellow  students  of  Mondino  at  the  Uni- 
versity of  Bologna  had  been  Mondeville.  He  came 
from  distant  France  to  take  a  course  in  surgery  with 

1  Physicians  wore  a  particular  garb  consisting  of  a  cloak  and  often 
a  mask,  supposed  to  protect  them  from  infections  at  this  time,  so 
that  it  was  not  difficult  to  make  a  characteristic  picture  as  a  sign  for 
a  pharmacy.  These  symbolic  signs  were  much  commoner  and  very 
necessary  when  people  generally  were  not  able  to  read.  It  is  from 
that  period  that  we  have  the  mortar  and  pestle  as  also  the  colored 
lights  in  the  windows  of  the  drug  stores,  and  the  many-colored 
barber-pole.  Also  the  big  boot,  key,  watch,  hat,  bonnet,  and  the 
like,  the  last  symbolic  sign  invention  apparently  being  the  wooden 
Indian  for  the  tobacco  store. 


208  OLD-TIME  MAKERS  OF  MEDICINE 

Theodoric,  whose  high  reputation  in  the  olden  time, 
vague  with  us  half  a  century  ago,  is  now  amply 
justified  by  what  we  know  of  him  from  such  ardent 
students  and  admirers  as  Pagel  and  Nicaise.  Not 
long  after  Mondino's  death,  Guy  de  Chauliac  came 
from  France  to  reap  similar  opportunities  to  these, 
which  had  proved  so  fruitful  for  Mondeville.  The 
more  that  we  learn  about  this  time  the  more  do  we 
find  to  make  it  clear  how  deeply  interested  the  gen- 
eration was  in  education  in  every  form,  artistic, 
philosophic,  but,  also,  though  this  is  often  not 
realized,  scientific. 

The  long  distances,  so  much  longer  in  that  time 
than  in  ours,  to  which  men  were  willing,  and  even 
anxious,  to  go,  in  order  to  obtain  opportunities  for 
research,  and  to  get  in  touch  with  a  special  master, 
the  associations  with  stimulating  fellow  pupils  of 
other  lands,  the  scientific  correspondences,  almost 
necessarily  initiated  by  such  circumstances,  all  in- 
dicate an  enthusiasm  for  knowledge  such  as  we  have 
not  been  accustomed  to  attribute  to  this  period.  On 
the  contrary,  we  have  been  rather  inclined  to  think 
them  neglectful  of  all  education,  and  have,  above  all, 
listened  acquiescently  while  men  deprecated  the 
lack  of  interest  in  things  scientific  displayed  by 
these  generations.  Indeed,  many  writers  have  gone 
out  of  their  way  to  find  a  reason  for  the  supposed 
lack  of  interest  in  science  at  this  time,  and  have 
proclaimed  the  Church's  opposition  to  scientific  edu- 
cation and  study  as  the  cause. 

At  this  time  Italy  was  the  home  of  the  graduate 
teaching  for  all  Europe.  The  Italian  Peninsula  con- 
tinued to  be  the  foster-mother  of  the  higher  educa- 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA    209 

tion  in  letters  and  art,  but  also,  though  this  is  less 
generally  known,  in  science,  for  the  next  five  cen- 
turies. Germany  has  come  to  be  the  place  of  pil- 
grimage for  those  who  want  higher  opportunities 
in  science  than  can  be  afforded  in  their  own  coun- 
try only  during  the  latter  half  of  the  nineteenth 
century.  France  occupied  it  during  the  first  half 
of  the  nineteenth  century.  Except  for  short  inter- 
vals, when  political  troubles  disturbed  Italy,  as 
about  the  middle  of  the  fourteenth  century,  when 
the  removal  of  the  Popes  to  Avignon  brought  their 
influence  for  education  over  to  France  and  a  short 
period  at  the  beginning  of  the  eighteenth  century, 
when  the  Netherlands  for  a  time  came  into  educa- 
tional prominence,  Italy  has  always  been  the 
European  Mecca  for  advanced  students.  Prac- 
tically all  our  great  discoverers  in  medicine,  until 
the  last  century,  were  either  Italians,  or  else  had 
studied  in  Italy.  Mondino,  Bertrucci,  Salicet,  Lan- 
franc,  Baverius,  Berengarius,  John  De  Vigo,  who 
first  wrote  on  gun-shot  wounds ;  John  of  Arcoli,  first 
to  mention  gold  filling  and  other  anticipations  of 
modern  dentistry;  Varolius,  Eustachius,  Caesal- 
pinus,  Columbus,  Malpighi,  Lancisi,  Morgagni,  Spal- 
lanzani,  Galvani,  Volta,  were  all  Italians.  Monde- 
ville,  Guy  de  Chauliac,  Linacre,  Vesalius,  Harvey, 
Steno,  and  many  others  who  might  be  named,  all 
studied  in  Italy,  and  secured  their  best  opportunities 
to  do  their  great  work  there. 

It  would  be  amusing,  if  it  were  not  amazing,  to 
have  serious  writers  of  history  in  the  light  of  this 
plain  story  of  graduate  teaching  of  science  in  Italy 
for  over  five  centuries,  write  about  the  opposition  of 


210  OLD-TIME  MAKEES  OF  MEDICINE 

the  Church  to  science  during  the  Medieval  and 
Renaissance  periods.  It  is  particularly  surprising 
to  have  them  talk  of  Church  opposition  to  the  med- 
ical sciences.  The  universities  of  the  world  all  had 
their  charters  from  the  Popes  at  this  time,  and  were 
all  ruled  by  ecclesiastics,  and  most  of  the  students 
and  practically  all  of  the  professors  down  to  the 
end  of  the  sixteenth  century  belonged  to  the  clerical 
order.  The  universities  of  Italy  were  all  more  di- 
rectly under  the  control  of  ecclesiastical  authority 
than  anywhere  else,  and  nearly  all  of  them  were 
dominated  by  papal  influence.  Bologna,  while  do- 
ing much  of  the  best  graduate  work  in  science,  espe- 
cially in  medicine,  was,  in  the  Papal  States,  abso- 
lutely under  the  rule  of  the  Popes.  The  university 
was,  practically,  a  department  of  the  Papal  govern- 
ment. The  medical  school  at  the  University  of 
Rome  itself  was  for  several  centuries,  at  the  end  of 
the  Middle  Ages,  the  teaching-place  where  were  as- 
sembled the  pick  of  the  great  medical  investigators, 
who,  having  reached  distinction  by  their  discoveries 
elsewhere,  were  summoned  to  Rome  in  order  to  add 
prestige  to  the  Papal  University.  All  of  them  be- 
came special  friends  of  the  Popes,  dedicated  their 
books  to  them,  and  evidently  looked  to  them  as 
beneficent  patrons  and  hearty  encouragers  of 
original  scientific  research. 

While  this  is  so  strikingly  true  of  medical  science 
as  to  make  contrary  declarations  in  the  matter  ut- 
terly ridiculous,  and  to  suggest  at  once  that  there 
must  be  some  motive  for  seeing  things  so  different 
to  the  reality,  the  same  story  can  be  told  of  graduate 
science  in  other  departments.    It  was  to  Italy  that 


«      i\ 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA    211 

men  came  for  special  higher  studies  in  mathematics 
and  astronomy,  in  botany,  in  mineralogy,  and  in  ap- 
plied chemistry,  so  far  as  it  related  to  the  arts  of 
painting,  illuminating,  stained-glass  making,  and  the 
like.  No  student  of  science  felt  that  he  had  quite 
exhausted  the  opportunities  for  study  that  were  pos- 
sible for  him  until  he  had  been  down  in  Italy  for 
some  time.  To  meet  the  great  professors  in  Italy 
was  looked  on  as  sure  to  be  a  source  of  special  in- 
centive in  any  department  of  science.  This  is  com- 
ing to  be  generally  recognized  just  in  proportion 
as  our  own  interest  in  the  arts  and  crafts,  and  in 
the  history  of  science,  leads  us  to  go  carefully  into 
the  details  of  these  subjects  at  first  hand.  The 
editors  of  the  "  Cambridge  Modern  History,"  in 
their  preface,  declared  ten  years  ago  that  we  can 
no  longer  accept  with  confidence  the  declaration  of 
any  secondary  writer  on  history.  This  is  par- 
ticularly true  of  the  medieval  period.  We  must  go 
back  to  the  writers  of  those  times. 

If  it  seems  surprising  that  the  University  of  Bo- 
logna should  have  come  into  such  great  prominence 
as  an  institute  for  higher  education  at  this  time,  it 
would  be  well  to  recall  some  of  the  great  work  that 
is  being  done  in  this  part  of  Italy  in  other  depart- 
ments at  this  time.  Cimabue  laid  the  foundation  of 
modern  art  towards  the  end  of  the  thirteenth  cen- 
tury, and  during  Mondino's  life  Giotto,  his  pupil, 
raised  an  artistic  structure  that  is  the  admiration 
of  all  generations  of  artists  since.  Dante's  years 
are  almost  exactly  contemporary  with  those  of 
Giotto  and  of  Mondino.  If  men  were  doing  such 
wondrous  work  in  literature  and  in  art,  why  should 


212  OLD-TIME  MAKERS  OF  MEDICINE 

not  the  same  generation  produce  a  man  who  will  ac- 
complish for  the  practical  science  of  medicine  what 
his  friends  and  contemporaries  had  done  in  other 
great  intellectual  departments. 

In  recent  years  we  have  come  to  think  much  more 
of  environment  as  an  influence  in  human  develop- 
ment and  accomplishment  than  was  the  custom  some- 
time ago.  The  broader  general  environment  in 
Italy,  with  genius  at  work  in  other  departments,  was 
certainly  enough  to  arouse  in  younger  minds  all 
their  powers  of  original  work.  The  narrower  en- 
vironment at  Bologna  itself  was  quite  as  stimulat- 
ing, for  a  great  clinical  teacher,  Taddeo  Alderotti, 
had  come,  in  1260,  from  Florence  to  Bologna,  to  take 
up  there  the  practice  and  teaching  of  medicine.  It 
was  under  him  that  Mondino  was  to  be  trained  for 
his  life  work. 

To  understand  the  place  of  Mondino,  and  of  the 
medical  school  of  Bologna,  in  his  time,  and  the  repu- 
tation that  came  to  them  as  world  teachers  of  medi- 
cine, we  must  know,  first,  this  great  teacher  of  Mon- 
dino and  the  atmosphere  of  progressive  medicine 
that  enveloped  the  university  in  the  latter  half  of 
the  thirteenth  century.  In  the  chapter  on  "  Great 
Surgeons  of  the  Medieval  Universities  ' '  we  call  par- 
ticular attention  to  the  series  of  distinguished  men, 
the  first  four  of  whom  were  educated  at  Salerno,  and 
who  came  to  Bologna  to  teach  surgery.  They  were 
doing  the  best  surgery  in  the  world,  much  better 
than  was  done  in  many  centuries  after  their  time; 
indeed,  probably  better  than  at  any  period  down  to 
our  own  day.  Besides,  they  seem  to  have  been  mag- 
netic teachers  who  attracted  and  inspired  pupils. 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     213 

We  have  the  surgical  contributions  of  a  series  of 
men,  written  at  Bologna,  that  serve  to  show  what 
fine  work  was  accomplished.  At  this  time,  however, 
the  field  of  medicine  was  not  neglected,  thongh  we 
have  but  a  single  great  historical  name  in  it  that  has 
lived.  This  was  Taddeo  Alderotti,  a  man  who  lifted 
the  medical  profession  as  high  in  the  estimation  of 
his  fellow  citizens  at  Florence  as  the  great  painters 
and  literary  men  of  his  time  did  their  depart- 
ments, and  who  then  moved  to  Bologna,  because  of 
the  opportunity  to  teach  afforded  him  by  the  uni- 
versity. 

It  is  sometimes  a  little  difficult  for  casual  students 
of  the  time  to  understand  the  marvellous  repu- 
tation acquired  by  this  medieval  physician.  It 
should  not  be,  however,  when  we  recall  the  enthusi- 
astic reception  and  procession  of  welcome  accorded 
to  Cimabue's  Madonna,  and  the  almost  universal 
acclaim  of  the  greatness  of  Dante's  work,  even  in 
his  own  time.  In  something  of  that  same  spirit  Bo- 
logna came  to  appreciate  Taddeo,  as  he  is  familiarly 
known,  looked  upon  him  as  a  benefactor  of  the  com- 
munity, and  voted  to  relieve  him  of  the  burden  of 
paying  taxes.  He  came  to  be  considered  as  a  pub- 
lic institution,  whose  presence  was  a  blessing  to  his 
fellow  citizens,  and  whose  goodness  to  them  should 
be  recognized  in  this  public  way.  One  is  not  sur- 
prised to  hear  Villani,  the  well-known  contemporary 
historian,  speak  of  him  as  the  greatest  physician  in 
Christendom. 

The  feelings  of  the  citizens  of  Bologna,  it  may 
well  be  confessed,  were  not  entirely  unselfish,  or 
due  solely  to  the  desire  to  encourage  a  great  sci- 


214  OLD-TIME  MAKEBS  OF  MEDICINE 

entific  genius.  Few  men  of  his  generation  had  done 
more  for  the  city  in  a  material  way  quite  apart  from 
whatever  benefits  he  conferred  upon  the  health  of 
its  citizens  than  Dr.  Taddeo.  It  was  he  who  or- 
ganized medical  teaching  in  the  city  on  such  a  plane 
that  it  attracted  students  from  all  over  the  world. 
Bologna  had  had  a  great  law  school  before  this, 
founded  by  Irnerius,  to  which  students  had  come 
from  all  over  the  world.  With  the  advent  of  Tad- 
deo from  Florence,  and  his  success  as  a  medical 
practitioner,  there  began  to  flock  to  his  lectures 
many  students  who  spread  his  fame  far  and  wide. 
The  city  council  could  scarcely  do  less  than  grant  the 
same  privileges  to  the  medical  students  and  teachers 
of  Taddeo  's  school  as  they  had  previously  accorded 
to  the  faculty  of  law  and  its  students.  The  city 
council  recognized  quite  as  clearly  as  any  board  of 
aldermen  in  the  modern  time  how  much,  even  of 
material  benefit,  a  great  university  was  to  the  build- 
ing up  of  a  city,  though  their  motives  were  prob- 
ably much  higher  than  that,  and  their  enlightened 
policy  had  its  reward  in  the  rapid  growth  of  Bo- 
logna until,  very  probably  at  the  end  of  the  thir- 
teenth century,  it  had  more  students  than  any  uni- 
versity of  the  modern  time.  The  number  was  not 
less  than  fifteen  thousand,  and  may  have  been  twenty 
thousand. 

To  this  great  university  success  Taddeo  and  his 
medical  school  contributed  not  a  little.  The  espe- 
cially attractive  feature  of  his  teaching  seems  to 
have  been  its  eminent  practicalness.  He  himself 
had  made  an  immense  success  of  the  practice  of 
medicine,  and  accumulated  a  great  fortune,  so  much 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA    215 

so  that  Dante,  in  his  "  Paradiso,"  when  he  wishes  to 
find  a  figure  that  would  represent  exactly  the  op- 
posite to  what  St.  Dominic,  the  founder  of  the 
Dominicans,  did  for  the  love  of  wisdom  and  hu- 
manity, he  takes  that  of  Taddeo,  who  had  accom- 
plished so  much  for  personal  reputation  and 
wealth. 

This  might  easily  lead  to  the  impression  that 
Taddeo 's  teaching  was  unscientific,  or  merely  em- 
piric, or  that  he  himself  was  a  narrow-minded  maker 
of  money,  intent  only  on  his  immediate  influence, 
and  hampered  by  exclusive  devotion  to  practical 
medicine.  Nothing  could  be  farther  from  the  truth 
than  any  such  impression.  Taddeo  was  not  only  the 
head  of  a  great  medical  school,  a  great  teacher  whom 
his  students  almost  worshipped,  a  physician  to  whom 
patients  flocked  because  of  his  marvellous  success, 
a  fine  citizen  of  a  great  city,  whom  his  fellow  citizens 
honored,  but  he  was  a  broad-minded  scholar,  a 
philosopher,  and  even  an  author  in  branches  apart 
from  medicine. 

In  that  older  time  it  was  the  custom  to  combine 
the  study  of  philosophy  and  medicine.  For  cen- 
turies after  that  period  in  Italy  it  was  the  custom 
for  men  to  take  both  degrees,  the  doctorate  in 
philosophy  and  in  medicine  at  the  same  time.  In- 
deed, most  of  those  whose  work  has  made  them 
famous,  down  to  and  including  Galvani,  did  so. 
Taddeo  wrote  commentaries  on  the  works  of  Hip- 
pocrates and  Galen,  but  he  also  translated  the 
ethics  of  Aristotle,  and  did  much  to  make  the  learn- 
ing of  the  Arabs  easily  available  for  his  students. 
His  was  a  broad,  liberal  scholarship.    Dr.  Lewis 


216  OLD-TIME  MAKERS  OF  MEDICINE 

Pilcher,  in  his  article  on  "  The  Mondino  Myth,"1 
does  not  hesitate  to  say  that  "  to  the  spirit  which, 
from  his  professorial  chair,  Taddeo  infused  into  the 
teaching  and  study  of  medicine  undoubtedly  is  due 
the  high  position  which  for  many  generations  there- 
after the  school  of  Bologna  continued  to  maintain  as 
a  centre  of  medical  teaching. ' ' 

Of  course,  erudition  had  its  revenge,  and  carried 
Taddeo  too  far.  The  difficult  thing  in  human 
nature  is  to  stay  in  the  mean  and  avoid  exaggera- 
tion. His  methods  of  illustrating  medical  truths 
from  many  literary  and  philosophical  sources  often 
caused  the  kernel  of  observation  to  be  hidden  be- 
neath a  blanket  of  speculation  or,  at  least,  to  be 
concealed  to  a  great  extent.  Even  the  Germans, 
who  have  insisted  most  on  this  unfortunate  tendency 
of  Taddeo,  have  been  compelled  to  confess  that  there 
is  much  that  is  valuable  in  what  he  accomplished, 
and  that  even  his  modes  of  expression  were  not 
without  a  certain  vivacity  which  attracted  atten- 
tion and  doubtless  added  materially  to  his  success 
as  a  teacher.  Pagel,  in  Puschmann's  "  Handbuch," 
says : '  '  It  cannot  be  denied  [this  is  just  after  he  has 
quoted  a  passage  of  Taddeo  with  regard  to  dreams] 
that  Taddeo's  expressions  have  a  certain  liveliness 
all  their  own  that  gives  us  some  idea  why  he  was 
looked  upon  as  so  good  a  teacher,  a  teacher  who,  as 
we  know  now,  also  gave  instruction  by  the  bedside 
of  patients. ' '  Pagel  adds, ' '  Taddeo  's  greatest  merit 
and  his  highest  significance  in  medical  education 
consist  in  the  fact  that  a  great  many  (zahlreiche) 

1  The  Medical  Library  and  Historical  Journal,  Brooklyn,  December, 
1906. 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     217 

physicians  followed  directly  in  his  footsteps  and 
were  counted  as  his  pupils.  They  were  all  men,  as 
we  know  them,  who  as  writers  and  practitioners  of 
medicine  succeeded  in  going  far  beyond  the  level  of 
mediocrity  in  what  they  accomplished. ' ' 

This  was  the  teacher  who  most  influenced  young 
Mondino  when  he  came  to  the  University  of  Bo- 
logna, for  it  seems  not  unlikely  that  as  a  medical 
student  he  was  actually  the  pupil  of  Taddeo,  then 
in  a  vigorous  old  age.  If  not,  he  was  at  least  brought 
under  the  direct  influence  of  the  teaching  tradition 
created  during  more  than  thirty  years  by  that  won- 
derful old  man.  Knowing  what  we  do  of  Taddeo  it 
is  not  surprising  that  his  pupil  should  have  accom- 
plished work  that  was  to  influence  succeeding  gen- 
erations more  than  any  other  of  that  wonderful 
thirteenth  century.  Dr.  Pilcher  in  the  article  on 
*  '  The  Mondino  Myth, ' '  so  often  placed  under  contri- 
bution in  this  sketch,  says  that  "  It  needs  no  great 
stretch  of  the  imagination  to  picture  somewhat  of 
the  effect  that  contact  with  such  a  man  as  Taddeo  di 
Alderotto  1  might  have,  in  molding  the  character  of 
his  young  neighbor  and  pupil,  the  chemist's  son,  who 
a  few  years  later,  by  his  devotion  to  the  study  of 
human  anatomy,  was  to  re-establish  the  practical 

1  Taddeo,  who  was  born  in  1215,  according  to  our  usually  accepted 
traditions  in  the  matter,  would  have  been  seventy-five  years  of  age 
when  Mondino  as  a  youth  of  scarcely  more  than  fifteen  went  to 
the  University.  It  might  seem  that  so  old  a  man  would  have  very 
little  influence  over  the  young  man.  Taddeo,  however,  had,  as  we 
have  said,  a  very  strenuous  old  age.  Everything  in  life  had  come  to 
him  late.  He  was  well  past  thirty  before  he  began  to  study  philoso- 
phy and  medicine,  having  been  a  seller  of  candles  from  necessity  be- 
cause of  poverty  in  his  younger  years.  His  great  success  in  practice 
came  when  he  was  past  forty.    He  first  began  to  teach  when  he  was 


218  OLD-TIME  MAKERS  OF  MEDICINE 

pursuit  of  study  on  the  human  cadaver  as  the  com- 
mon privilege  of  the  skilled  physician,  and  was  to 
engrave  his  own  name  deeply  on  the  records  of 
medicine. ' ' 

Under  this  worthy  compatriot  and  contemporary 
of  the  great  Florentines,  Mondino  was  inspired  to  be 
the  teacher  that  did  so  much  for  Bologna.  Until 
recent  years  it  has  usually  been  the  custom  to  give 
too  much  significance  to  the  work  of  the  men  whose 
names  stand  out  most  prominently  in  the  early  his- 
tory of  departments  of  the  intellectual  life.  Mon- 
dino Js  reputation  has  shared  in  this  exaggerative 
tendency  to  some  extent,  hence  the  necessity  for 
realizing  what  was  accomplished  before  his  time  and 
the  fact  that  he  only  stands  as  the  culmination  of  a 
progressive  period.  Carlyle  spoke  of  Dante  as  the 
man  in  whom  "  ten  silent  centuries  found  a  voice." 
The  centuries,  however,  were  only  silent  because  the 
moderns  did  not  know  how  to  listen  to  their  mes- 
sage. We  know  now  that  every  country  in  Europe 
had  a  great  contributor  to  literature  in  the  century 
before  Dante.  The  Cid,  the  Arthur  Legends,  the 
Nibelungen,  the  Troubadours,  naturally  led  up  to 
Dante.  He  was  only  the  culmination  of  a  great  period 

forty-five,  and  he  was  nearly  fifty-five  before  he  began  to  write. 
According  to  tradition  he  married  when  he  was  nearly  eighty — ■ 
whether  for  the  first  or  second  time  is  not  said — and  while  this  might 
be  considered,  and  would  in  some  cases  be,  an  indication  of  weak- 
ness of  character  (it  would  probably  depend  on  whether  he  married 
or  was  married ) ,  it  seems  in  his  case  to  have  indicated  a  vigor  of 
body  and  character  which  shows  very  clearly  how  great  was  the  pos- 
sibility of  his  influence  as  a  teacher  having  been  maintained  even 
up  to  this  late  time  of  life,  and  thus  influencing  a  pupil  who  is  to 
represent  the  most  potent  influence  at  the  beginning  of  the  next 
century. 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     219 

of  literature.  We  know  now  that  men  had  worked 
in  art  before  Cimabue  and  Giotto,  and  had  done  im- 
pressive work  that  made  for  the  progress  of  art. 
These  names,  however,  have  come  to  represent  in 
many  minds  the  sort  of  solitary  phenomena  that 
Dante  has  seemed  sometimes  even  to  scholars. 

Because  Mondino  did  such  good  work  in  medical 
teaching  it  is  sometimes  declared,  even  in  rather  seri- 
ous histories,  that  he  was  the  first  to  accomplish  any- 
thing in  his  department,  and  that  before  his  time 
there  is  a  blank.  Some  historians,  for  instance,  have 
insisted  that  Mondino  was  the  first  to  do  human  dis- 
sections, and  that  he  did  at  most  but  two  or  three. 
Only  those  who  are  unacquainted  with  the  magnifi- 
cent development  of  surgery  that  took  place  during 
the  preceding  century,  the  evidence  for  which  is  so 
abundantly  given  in  modern  historians  of  medicine 
and  especially  in  Gnrlt's  great  work  on  the  history 
of  surgery,  from  which  we  have  quoted  enough  to 
give  a  good  idea  of  the  extent  to  which  the  move- 
ment went,  are  likely  to  accept  any  such  declaration. 
There  could  not  have  been  all  that  successful  sur- 
gery without  much  dissection  not  only  of  animals 
but  also  of  human  bodies.  The  teaching  of  dissec- 
tion was  not  regularly  organized  until  Mondino 's 
time,  but  it  seems  very  clear  that  even  he  must  have 
dissected  many  more  bodies  than  the  number  usually 
attributed  to  him.  Professor  Lewis  Stephen  Pilcher 
of  Brooklyn,  who  made  a  special  study  of  Mondino 
traditions  in  Bologna  itself,  and  collected  some  of  the 
early  editions  of  his  books,  feels  so  acutely  the  ab- 
surdity of  the  ordinarily  accepted  tradition  in  this 
matter,  that  he  has  written  a  paper  on  the  subject 


220  OLD-TIME  MAKEBS  OF  MEDICINE 

bearing  the  suggestive  title,  "  The  Mondino  Myth." 
He  says : x 

"  We  are  accustomed  to  think  cf  the  practice  of 
dissection  as  having  been  re-created  by  Mondino,  and 
at  once  fully  developed,  springing  into  acceptance. 
The  year  1315  is  the  generally  accepted  date  for  the 
first  public  anatomical  demonstration  upon  a  human 
body  made  by  Mondino,  and  yet  it  is  true  that  among 
the  laws  promulgated  by  Frederick  II,  more  than 
seventy-five  years  before  (a.d.  1231),  was  included 
a  decree  that  a  human  body  should  be  dissected  at 
Salernum  at  least  once  in  five  years  in  the  presence 
of  the  assembled  physicians  and  surgeons  of  the 
kingdom,  and  that  in  the  regulations  established  for 
admission  to  the  practice  of  medicine  and  surgery 
in  the  kingdom  it  was  decreed  that  no  surgeon  should 
be  admitted  to  practise  unless  he  should  bring  testi- 
monials from  the  masters  teaching  in  the  medical 
faculty,  that  he  was  l  learned  in  the  anatomy  of 
human  bodies,  and  had  become  perfect  in  that  part 
of  medicine  without  which  neither  incisions  could 
safely  be  made  nor  fractures  cured.' 

"  Salernum  was  notable  in  its  legalization  of  the 
dissection  of  human  bodies  before  the  first  public 
work  of  Mondino,  for,  according  to  a  document  of 
the  Maggiore  Consiglio  of  Venice  of  1308,  it  appears 
that  there  was  a  college  of  medicine  at  Venice  which 
was  even  then  authorized  to  dissect  a  body  every 
year.  Common  experience  tells  us  that  the  embodi- 
ment of  such  regulations  into  formal  law  would 
occur  only  after  a  considerable  preceding  period  of 
discussion,  and  in  this  particular  field  of  clandestine 
practice.  It  is  too  much  to  ask  us  to  believe  that 
in  all  this  period,  from  the  date  of  the  promulgation 
of  Frederick's  decree  of  1231  to  the  first  public  dem- 
onstration by  Mondino,  at  Bologna  in  1315,  the  de- 

1  Medical  Library  and  Historical  Journal,  1906. 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     221 

cree  had  been  a  dead  letter  and  no  human  body 
had  been  anatomized.  It  is  true  there  is  not,  as  far 
as  I  am  aware,  any  record  of  any  such  work,  and 
commentators  and  historians  of  a  later  date  have, 
without  exception,  accepted  the  view  that  none  was 
done,  and  thereby  heightened  the  halo  assigned  to 
Mondino  as  the  one  who  ushered  in  a  new  era.  Such 
a  view  seems  to  me  to  be  incredible.  Be  that  as  it 
may,  it  is  undeniable  that  at  the  beginning  of  the 
14th  century  the  idea  of  dissecting  the  human 
body  was  not  a  novel  one;  the  importance  of  a 
knowledge  of  the  intimate  structure  of  the  body  had 
already  been  appreciated  by  divers  ruling  bodies, 
and  specific  regulations  prescribing  its  practice  had 
been  enacted.  It  is  more  reasonable  to  believe  that 
in  the  era  immediately  preceding  that  of  Mondino 
human  bodies  were  being  opened  and  after  a  fash- 
ion anatomized.  All  that  we  know  of  the  work  of 
Mondino  suggests  that  it  was  not  a  new  enterprise 
in  which  he  was  a  pioneer,  but  rather  that  he  brought 
to  an  old  practice  a  new  enthusiasm  and  better  meth- 
ods, which,  caught  on  the  rising  wave  of  interest  in 
medical  teaching  at  Bologna,  and  preserved  by  his 
own  energy  as  a  writer  in  the  first  original  system- 
atic treatise  written  since  the  time  of  Galen,  created 
for  him  in  subsequent  uncritical  times  the  reputation 
of  being  the  Kestorer  of  the  practice  of  anatomizing 
the  human  body,  the  first  one  to  demonstrate  and 
teach  such  knowledge  since  the  time  of  the  Ptolemaic 
anatomists,  Erasistratus  and  Herophilus. 

"  The  changes  have  been  rung  by  medical  his- 
torians upon  a  casual  reference  in  Mondino 's  chapter 
on  the  uterus  to  the  bodies  of  two  women  and  one 
sow  which  he  had  dissected,  as  if  these  were  the  first 
and  the  only  cadavers  dissected  by  him.  The  con- 
text involves  no  such  construction.  He  is  enforcing 
a  statement  that  the  size  of  the  uterus  may  vary, 
and  to  illustrate  it  remarks  that  'a  woman  whom  I 


222  OLD-TIME  MAKERS  OF  MEDICINE 

anatomized  in  the  month  of  January  last  year,  viz., 
1315  Anno  Christi,  had  a  larger  uterus  than  one 
whom  I  anatomized  in  the  month  of  March  of  the 
same  year.'  And  further,  he  says  that  '  the  uterus 
of  a  sow  which  I  dissected  in  1316  (the  year  in  which 
he  was  writing)  was  a  hundred  times  greater  than 
any  I  have  seen  in  the  human  female,  for  she  was 
pregnant  and  contained  thirteen  pigs.'  These  hap- 
pen to  be  the  only  reference  to  specific  bodies  that 
he  makes  in  his  treatise.  But  it  is  a  far  cry  to  wring 
out  of  these  references  the  conclusion  that  these  are 
the  only  dissections  he  made.  It  is  quite  true  that 
if  we  incline  to  enshroud  his  work  in  a  cloud  of  mys- 
tery and  to  figure  it  as  an  unprecedented  awe-inspir- 
ing feature  to  break  down  the  prejudices  of  the  ages, 
it  is  easy  to  think  of  him  as  having  timidly  profaned 
the  human  body  by  his  anatomizing  zeal  in  but  one 
or  two  instances.  His  own  language,  however, 
throughout  his  book  is  that  of  a  man  who  was  fa- 
miliar with  the  differing  conditions  of  the  organs 
found  in  many  different  bodies;  a  man  who  was 
habitually  dissecting. ' ' 

(Quotations  from  the  work  of  Mundinus  showing 
his  familiarity  with  dissections.  The  leaf  and  line 
references  are  to  the  Dryander  edition,  Marburg, 
1541.) 

"I  do  not  consider  separately  the  anatomy  of 
component  parts,  because  their  anatomy  does  not 
appear  clearly  in  the  fresh  subject,  but  rather  in 
those  macerated  in  water."    (Leaf  2,  lines  8-13.) 

1  *  .  .  .  these  differences  are  more  noticeable  in  the 
cooked  or  perfectly  dried  body,  and  so  you  need  not 
be  concerned  about  them,  and  perhaps  I  will  make 
an  anatomy  upon  such  a  one  at  another  time  and 
will  write  what  I  shall  observe  with  my  own  senses, 
as  I  have  proposed  from  the  beginning.' '  (Leaf  60, 
lines  14-17.) 

"  What  the  members  are  to  which  these  nerves 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     223 

come  cannot  well  be  seen  in  such  a  dissection  as  this, 
but  it  should  be  liquefied  with  rain  water,  and  this  is 
not  contemplated  in  the  present  body."  (Leaf  60, 
lines  31-33.) 

"  After  the  veins  you  will  note  many  muscles  and 
many  large  and  strong  cords,  the  complete  anatomy 
of  which  you  will  not  endeavor  to  find  in  such  a  body 
but  in  a  body  dried  in  the  sun  for  three  years,  as  I 
have  demonstrated  at  another  time;  I  also  declared 
completely  their  number,  and  wrote  the  anatomy  of 
the  muscles  of  the  arms,  hands,  and  feet  in  a  lecture 
which  I  gave  over  the  first,  second,  third,  and  fourth 
subjects."    (Leaf  61,  lines  1-7.) 

Very  probably  the  best  evidence  that  we  have  of 
the  comparative  frequency  at  least  of  dissection  at 
this  time  is  to  be  found  in  the  records  of  a  trial  for 
body-snatching  that  occurred  in  Bologna.  The  de- 
tails would  remind  one  very  much  of  what  we  know 
of  the  difficulties  with  regard  to  dissection  in  America 
a  couple  of  generations  ago,  when  no  bodies  were 
provided  by  law  for  dissection  purposes.  In  the 
course  of  some  studies  for  the  history  of  the  New 
York  State  Medical  Society  (New  York,  1906)  I 
found  that  nearly  every  one  of  the  first  half  dozen 
presidents  of  the  New  York  Academy  of  Medicine, 
which  is  not  much  more  than  sixty  years  old,  had 
had  body-snatching  experiences  when  they  were 
younger.  Dr.  Samuel  Francis,  the  medico-historical 
writer,  tells  of  a  personal  expedition  across  the  ferry 
in  the  winter  time,  bringing  a  body  from  a  Long 
Island  graveyard.  In  order  to  avoid  the  constables 
on  the  Long  Island  side  and  the  police  on  the  New 
York  side,  because  there  had  been  a  number  of  cases 
of  body-snatching  recently  and  the  authorities  were 


224  OLD-TIME  MAKERS  OF  MEDICINE 

on  the  lookout,  the  corpse  was  placed  sitting  beside 
the  physician  who  drove  the  wagon,  with  a  cloak 
wrapped  around  it,  as  if  it  were  a  living  person 
specially  protected  against  the  cold.  Similar  experi- 
ences were  not  unusual.  The  lack  of  bodies  for  dis- 
section is  sometimes  attributed  to  religious  scruples, 
but  they  have  very  little  to  do  with  it,  as  at  all  times 
men  have  refused  to  allow  the  bodies  of  their  friends 
to  be  treated  as  anatomical  material.  This  is  the 
natural  feeling  of  abhorrence  and  not  at  all  religious. 
It  is  only  when  there  are  many  unclaimed  bodies  of 
strangers  and  the  poor,  as  happens  in  large  cities, 
that  there  can  be  an  abundance  of  anatomical 
material. 

The  details  of  this  body- snatching  case  are 
strangely  familiar  to  those  who  know  the  history  of 
similar  cases  before  the  middle  of  the  nineteenth  cen- 
tury. The  case  occurred  in  1319  in  Bologna,  just 
four  years  after  Mondino's  public  dissections.  Four 
students  were  involved  in  the  charge  of  body-snatch- 
ing, all  of  them  from  outside  the  city  of  Bologna  it- 
self, three  from  Milan  and  one  from  Piacenza.  In 
modern  experience,  too,  as  a  rule,  students  from  out- 
side of  the  town  where  the  medical  college  was  situ- 
ated, were  always  a  little  readier  than  natives  to 
violate  graveyards.  These  four  students  were  ac- 
cused of  having  gone  at  night  to  the  Cemetery  of 
St.  Barnabas,  outside  the  gate  of  San  Felice, — 
suburban  graveyards  were  usually  the  scene  of  such 
exploits, — and  to  have  dug  up  the  body  of  a  certain 
criminal  named  Pasino,  who  had  been  hanged  a  few 
days  before.  They  carried  the  body  to  the  school  in 
the  Parish  of  San  Salvatore,  where  Alberto  Zancari 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     225 

was  teaching.  The  resurrection  had  been  accom- 
plished without  witnesses,  but  there  were  several 
witnesses  who  testified  that  they  recognized  the  body 
of  Pasino  in  the  school  and  students  occupied  with 
its  dissection.  If  evidence  for  the  zeal  of  the  medi- 
cal students  of  that  time  for  dissection  were  needed, 
surely  we  have  it  in  the  testimony  at  this  trial.  At 
a  time  when  body-snatching  has  become  a  criminal 
offence  usually  there  have  been  many  repeated  oc- 
currences of  it  before  the  parties  are  brought  to  trial, 
so  that  it  seems  not  unlikely  that  a  good  many  dis- 
sections of  illegally  secured  bodies  were  being  done 
at  Bologna  at  this  time. 

We  know  of  a  regulation  of  the  University  in 
force  at  this  time,  which  required  the  teachers 
at  the  University  to  do  an  anatomy  or  dissection  for 
students  if  they  secured  a  body  for  that  purpose. 
The  students  seem  to  have  used  all  sorts  of  influ- 
ence, political,  monetary,  diplomatic,  and  ecclesiasti- 
cal, in  order  to  secure  the  bodies  of  criminals.  Some- 
times when  they  failed  in  their  purpose  they  waited 
until  after  burial  and  then  took  the  body  without 
leave.  When  we  recall  the  awfully  deterrent  condi- 
tion in  which  bodies  must  have  been  that  were  thus 
provided  for  dissecting  purposes,  it  is  easy  to  under- 
stand that  the  enthusiasm  of  the  students  for  dis- 
section must  have  been  at  a  very  high  pitch.  Cer- 
tainly it  was  far  higher  than  at  the  present  day, 
when,  in  spite  of  the  fact  that  our  dissecting-rooms 
have  very  few  of  the  old-time  dangers  and  unpleas- 
antnesses, dissection  is  only  practised  with  assiduity 
if  special  care  is  exercised  in  requiring  attendance 
and  superintending  the  work  of  the  department. 


226  OLD-TIME  MAKEES  OF  MEDICINE 

In  my  book  on  "  The  Popes  and  Science  "  I  have 
gathered  the  traditions  relating  to  Mondino 's  as- 
sistants in  the  chair  of  anatomy  at  Bologna.  They 
furnish  abundant  evidence  of  the  fact  that  dissec- 
tions, far  from  being  uncommon,  must  have  been  not 
at  all  infrequent  at  the  north  Italian  universities  at 
this  time.  Curiously  enough,  one  of  these  assistants 
was  a  young  woman  who,  as  was  not  infrequently  the 
custom  at  this  time  in  the  Italian  universities,  was 
matriculated  as  a  student  at  Bologna.  She  took  up 
first  philosophy,  and  afterwards  anatomy,  under 
Mondino.  While  it  is  not  generally  realized,  co-educa- 
tion was  quite  common  at  the  Italian  universities  of 
the  thirteenth  and  fourteenth  centuries,  and  at  no 
time  since  the  foundation  of  the  universities  has  a 
century  passed  in  Italy  without  distinguished  women 
occupying  professors'  chairs  at  some  of  the  Italian 
universities.  This  young  woman,  Alessandra  Gili- 
ani,  of  Persiceto,  a  country  district  not  far  from 
Bologna,  took  up  the  study  of  anatomy  with  ardor 
and,  strange  as  it  may  appear,  became  especially 
enthusiastic  about  dissection.  She  became  so  skilful 
that  she  was  made  the  prosector  of  anatomy,  that  is, 
one  who  prepares  bodies  for  demonstration  by  the 
professors. 

According  to  the  "  Cronaca  Persicetana,"  quoted 
by  Medici  in  his  "  History  of  the  Anatomical  School 
at  Bologna  ' ' : 

"  She  became  most  valuable  to  Mondino  because 
she  would  cleanse  most  skilfully  the  smallest  vein, 
the  arteries,  all  ramifications  of  the  vessels,  without 
lacerating  or  dividing  them,  and  to  prepare  them  for 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA    227 

demonstration  she  would  fill  them  with  various 
colored  liquids,  which,  after  having  been  driven  into 
the  vessels,  would  harden  without  destroying  the  ves- 
sels. Again,  she  would  paint  these  same  vessels  to 
their  minute  branches  so  perfectly  and  color  them  so 
naturally  that,  added  to  the  wonderful  explanations 
and  teachings  of  the  master,  they  brought  him  great 
fame  and  credit.' '  The  whole  passage  shows  a  won- 
derful anticipation  of  our  most  modern  methods — 
injection,  painting,  hardening — of  making  anatom- 
ical preparations  for  class  and  demonstration  pur- 
poses. 

Some  of  the  details  of  the  story  have  been  doubted, 
but  her  memorial  tablet,  erected  at  the  time  of  her 
death  in  the  Church  of  San  Pietro  e  Marcellino  of 
the  Hospital  of  Santa  Maria  de  Mareto,  gives  all  the 
important  facts,  andiells  the  story  of  the  grief  of  her 
fiance,  who  was  himself  Mondino's  other  assistant.1 
This  was  Otto  Agenius,  who  had  made  for  himself  a 
name  as  an  assistant  to  the  chair  of  anatomy  in 
Bologna,  and  of  whom  there  were  great  hopes  enter- 
tained because  he  had  already  shown  signs  of  genius 
as  an  investigator  in  anatomy.  These  hopes  were 
destined  to  grievous  disappointment,  however,  for 
Otto  died  suddenly,  before  he  had  reached  his  thirti- 
eth year.  The  fact  that  both  these  assistants  of  Mon- 
dino  died  young  and  suddenly,  would  seem  to  point 

xPilcher  (loc.  cit.)  tells  of  her  tomb.  I  venture  to  change  his 
translation  of  the  inscription  in  certain  unimportant  particulars. 
He  says: 

"We  know  the  very  place  where  she  was  buried  in  front  of  the 
Madonna  delle  Lettre  in  the  Church  of  San  Pietro  e  Marcellino  of  the 


228  OLD-TIME  MAKERS  OF  MEDICINE 

to  the  fact  that  probably  dissection  wounds  in  those 
early  days  proved  even  more  fatal  than  they  occa- 
sionally did  a  century  or  more  ago,  when  the  proper 
precautions  against  them  were  not  so  well  under- 
stood. The  death  of  Mondino's  two  prosectors  in 
early  years  would  seem  to  hint  at  some  such  un- 
fortunate occurrence. 

As  regards  the  evidence  of  what  the  young  man 
had  accomplished  before  his  untimely  death,  prob- 
ably the  following  quotation,  which  Medici  has  taken 

Hospital  of  Santa  Maria  de  Mareto,  where  her  associate,  Agenio, 
mourning  and  inconsolable,  placed  a  tablet  with  this  inscription: 

D  .  O  .  M  . 

Vrceo  .  Contenti 

Alexandrae  .  Galinae  .  Pvellae  .  Persicetanae 

Penicillo  .  Egregiae  .  Ad  .  Anatomen  .  Exhibendam 

Et  .  Insignissimi  .  Medici  .  Mundini  .  Lucii 

Paucis  .  Comparandae  .  Discipulae  .  Cineres 

Carnis  .  Hie  .  Expectant  .  Resurrectionem 

Vixit  .  Ann  .  XIX  .  Obiit  .  Studio  .  Absunta 

Die  XXVI  Martii  .  A  .  S  .  MCCCXXVI 

Otto  .  Agenius  .  Lustrulanus  .  Ob  .  Earn  .  Demptam 

Sui  .  Potiori  .  Parte  .  Spoliatus  .  Sodali  .  Eximiae 

Ac  .  De  .  Se  .  Optime  .  Meritae  .  Inconsolabilis  .  M  .  P  . 

This  inscription  may  be  translated  as  follows: 

In  this  urn  enclosed 
The  ashes  of  the  body  of 
Alexandra  Giliani,  a  maiden  of  Periceto; 
Skilful  with  her  brush  in  anatomical  demonstrations 

And  a  disciple  equalled  by  few, 
Of  the  most  noted  physician,  Mundinus  of  Luzzi, 

Await  the  resurrection. 

She  lived  19  years:  she  died  consumed  by  her  labors 

March  26,  in  the  year  of  grace   1326. 

Otto  Agenius  Lustrulanus,  by  her  taking  away 

Deprived  of  his  better  part,  his  excellent  companion, 

Deserving  of  the  best, 

Has  erected  this  tablet." 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     229 

from  one  of  the  old  chroniclers,  will  give  the  best 
idea : 

* '  What  advantage  indeed  might  not  Bologna  have 
had  from  Otto  Agenius  Lustrulanus,  whom  Mon- 
dino  had  used  as  an  assiduous  prosector,  if  he  had 
not  beeen  taken  away  by  a  swift  and  lamentable  death 
before  he  had  completed  the  sixth  lustrum  of  his 
life!  ,? 

How  well  the  tradition  created  by  Mondino  con- 
tinued at  the  university  will  be  best  understood  from 
what  we  know  of  Guy  de  Chauliac's  visit  to  the  medi- 
cal school  here  about  the  middle  of  the  century.  The 
great  French  surgeon  tells  us  that  he  came  to  Bo- 
logna to  study  anatomy  under  the  direction  of  Mon- 
dino ?s  successor,  Bertruccius.  When  he  wrote  his 
preface  to  his  great  surgery  he  recalled  this  teaching 
of  anatomy  at  Bologna  and  said,  "It  is  necessary 
and  useful  to  every  physician  to  know,  first  of  all, 
anatomy.  For  this  purpose  the  study  of  books  is 
indeed  useful,  but  it  is  not  sufficient  to  explain  those 
things  which  can  only  be  appreciated  by  the  senses 
and  which  need  to  be  seen  in  the  dead  body  itself. ' ' 
He  advises  his  students  to  consult  Mundinus'  treatise 
but  to  demonstrate  its  details  for  themselves  on  the 
dead  body.  He  relates  that  he  himself  had  often, 
multitoties,  done  this,  especially  under  the  direction 
of  Bertruccius  at  Bologna.  Curiously  enough,  as 
pointed  out  by  Professor  Pilcher,  Mondino  had  used 
this  same  word  multitotiens  (the  variant  spelling 
makes  no  difference  in  the  meaning)  in  speaking 
about  his  own  work.  In  describing  the  hypogastric 
lesion  he  mentions  that  he  had  demonstrated  cer- 
tain veins  in  it  many  times,  multitotiens. 


230  OLD-TIME  MAKERS  OF  MEDICINE 

Mondino  was  just  past  fifty  when  he  finished  his 
little  book  and  permitted  copies  of  it  to  be  made. 
Though  the  book  occurs  so  early  in  the  history  of 
modern  book-making  the  author  offers  his  excuses  to 
the  public  for  writing  it,  and  quotes  the  authority 
of  Galen,  to  whom  he  turns  in  other  difficult  situ- 
ations, for  justification.  As  prefaces  go,  Mondino 's 
is  so  like  that  of  many  an  author  of  more  recent 
date  that  his  words  have  a  bibliographic,  as  well  as 
a  personal,  interest.    He  said: 

' '  A  work  upon  any  science  or  art — as  saith  Galen 
— is  issued  for  three  reasons:  first,  that  one  may 
satisfy  his  friends.  Second,  that  he  may  exercise 
his  best  mental  powers.  Third,  that  he  may  be  saved 
from  the  oblivion  incident  to  old  age.  Therefore, 
moved  by  these  three  causes,  I  have  proposed  to  my 
pupils  to  compose  a  certain  work  on  medicine. 

"  And  because  a  knowledge  of  the  parts  to  be 
subjected  to  medicine  (which  is  the  human  body, 
and  the  names  of  its  various  divisions)  is  a  part 
of  medical  science,  as  saith  Averrhoes  in  his  first 
chapter,  in  the  section  on  the  definition  of  medicine, 
for  this  reason  among  others,  I  have  set  out  to  lay 
before  you  the  knowledge  of  the  parts  of  the  human 
body  which  is  derived  from  anatomy,  not  attempting 
to  use  a  lofty  style,  but  the  rather  that  which  is 
suitable  to  a  manual  of  procedure. ' ' 

Some  of  the  early  editions  of  Mondinus,  book  are 
said,  according  to  old  writers,  to  have  contained  illus- 
trations. None  of  these  copies  have  come  down  to 
us,  but  the  assertion  is  made  so  definitely  that  it 
seems  likely  to  have  been  the  case.  The  editions 
that  we  have  contain  wood  engravings  of  the  method 
of  making  a  dissection  as  frontispiece,  so  that  it 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA    231 

would  not  be  difficult  to  think  of  further  such  illus- 
trations having  been  employed  in  the  book  itself.  As 
we  note  in  the  chapter  on  "  Great  Surgeons  of  the 
Medieval  Universities,"  Mondeville,  according  to 
Guy  de  Chauliac,  had  pictures  of  anatomical  prepara- 
tions which  he  used  for  teaching  purposes.  It  is 
easy  to  understand  that  the  value  of  such  aids  would 
be  recognized  at  a  time  when  the  difficulty  of  preserv- 
ing bodies  made  it  necessary  to  do  dissections  hur- 
riedly so  as  to  get  the  rapidly  decomposing  material 
out  of  the  way. 

Beyond  his  book  and  certain  circumstances  con- 
nected with  it  we  know  very  little  about  Mondino. 
What  we  know,  however,  enables  us  to  conclude  that, 
like  many  another  great  teacher,  he  must  have  had 
the  special  faculty  of  inspiring  his  students  with  an 
ardent  enthusiasm  for  the  work  that  they  were  tak- 
ing under  him.  Hence  the  body- snatching  and  other 
stories.  Mondino  continued  to  be  held  in  high  esti- 
mation by  the  Bolognese  for  centuries  after  his 
death.  Dr.  Pilcher  calls  attention  to  the  fact  that 
his  sepulchral  tablet,  which  is  in  the  portico  of  the 
Church  of  San  Vitari  in  Bologna,  and  a  replica  of 
which  he  was  allowed  to  have  made  in  order  to  bring 
it  to  America,  is  the  only  one  of  the  sepulchral  tablets 
in  the  great  churches  of  Florence,  San  Domenico, 
San  Martino,  the  Cathedral  and  the  Cloister  of  San 
Giacomo  degli  Ermitani,  which  has  not  been  removed 
from  its  original  location  and  placed  in  the  halls  of 
the  Civic  Museum.  Their  removal  he  considers  "  a 
kind  of  desecration  which  does  violence  to  one's  sense 
of  sanctity  and  propriety."  "  Fortunately,  thus  far, 
the  Mondino  Tablet  has  escaped  the  spoiler."    Very 


232  OLD-TIME  MAKERS  OF  MEDICINE 

probably  Dr.  Pilcher's  replica  of  the  tablet  which  he 
was  required  to  deposit  in  the  Civic  Museum  at  the 
time  when  the  copy  was  made  to  be  brought  to 
America  may  save  the  tablet  to  be  seen  in  its  original 
position  for  many  generations. 

Mondino's  career  is  of  special  interest  because  it 
foreshadows  the  life  and  accomplishment  of  many 
another  maker  of  medicine  of  the  after  time.  He 
did  a  great  new  thing  in  medicine  in  organizing 
regular  public  dissections,  and  then  in  making  a 
manual  that  would  facilitate  the  work.  He  waited 
patiently  for  years  before  completing  his  book  in 
order  that  it  might  be  the  fruit  of  long  experience, 
and  so  be  more  helpful  to  others.  He  was  so  modest 
as  to  require  urging  to  secure  the  publication.  He 
had  the  reward  of  his  patience  in  the  popularity  of 
his  little  work  for  centuries  after  his  time.  The 
glimpse  that  we  get  of  his  relations  to  his  young 
assistants,  Agenius  and  Alessandra,  seems  to  show 
us  a  teacher  of  distinct  personal  magnetism.  Un- 
doubtedly the  reputation  of  his  book  did  much  for 
not  only  the  medical  school  of  the  University  of 
Bologna,  but  also  for  the  medical  schools  of  other 
north  Italian  universities,  and  helped  to  bring  to 
them  the  crowds  of  students  that  flocked  there  during 
the  fourteenth  and  fifteenth  centuries. 

Taddeo  and  Mondino  turned  the  attention  of  the 
medical  students  of  their  generations  Bolognawards. 
Before  that  time  they  had  mainly  gone  to  Salerno. 
After  their  time  most  of  the  ardent  students  of  medi- 
cine felt  that  they  must  study  for  a  time  at  least  at 
Bologna.  Other  important  medical  schools  of  Italian 
universities  at  Padua,  at  Vicenza,  at  Piacenza,  arose 


MONDINO  AND  MEDICAL  SCHOOL  OF  BOLOGNA     233 

and  prospered.  During  the  time  when  the  political 
troubles  of  Italy  reached  a  climax  about  the  middle 
of  the  fourteenth  century,  while  the  Popes  were  at 
Avignon,  there  was  a  remission  in  the  attendance  at 
all  the  Italian  universities,  but  with  the  Popes'  re- 
turn to  Eome  and  the  coming  of  even  comparative 
peace  to  Italy,  Bologna  once  more  became  the  term 
of  medical  pilgrimages  for  students  from  all  over 
the  world.  In  the  meantime  Mondino's  book  went 
forth  to  be  the  most  used  text-book  of  its  kind  until 
Vesalius,  great  work  came  to  replace  it.  To  have 
ruled  in  the  world  of  anatomy  for  two  centuries  as 
the  best  known  of  teachers  is  of  itself  a  distinction 
that  shows  us  at  once  the  teaching  power  and  the 
scientific  ability  of  this  professor  of  anatomy  of 
Bologna  in  the  early  fourteenth  century. 


GREAT  SURGEONS  OF  THE  MEDIEVAL 
UNIVERSITIES 

Strange  as  it  may  appear  to  those  who  have  not 
watched  the  development  of  our  knowledge  of  the 
Middle  Ages  in  recent  years  the  most  interesting 
feature  in  the  medical  departments  and,  indeed,  of 
the  post-graduate  work  generally  of  the  medieval 
universities,  is  that  in  surgery.  There  is  a  very  gen- 
eral impression  that  this  department  of  medicine  did 
not  develop  until  quite  recent  years,  and  that  par- 
ticularly it  failed  to  develop  to  any  extent  in  the 
Middle  Ages.  A  good  many  of  the  historians  of  this 
period,  indeed,  though  never  the  special  historians 
of  medicine,  have  even  gone  far  afield  in  order  to 
find  some  reason  why  surgery  did  not  develop  at  this 
time.  They  have  insisted  that  the  Church  by  its 
prohibition  of  the  shedding  of  blood,  first  to  monks 
and  friars,  and  then  to  the  secular  clergy,  prevented 
the  normal  development  of  surgery.  Besides  they 
add  that  Church  opposition  to  anatomy  completely 
precluded  all  possibility  of  any  genuine  natural  evo- 
lution of  surgery  as  a  science. 

There  is  probably  no  more  amusing  feature  of 
quite  a  number  of  supposedly  respectable  and  pre- 
sumably authoritative  historical  works  written  in 
English  than  this  assumption  with  regard  to  the  ab- 
sence of  surgery  during  the  later  Middle  Ages.    Only 

234 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    235 

the  most  complete  ignorance  of  the  actual  history  of 
medicine  and  surgery  can  account  for  it.  The  writers 
who  make  such  assertions  must  never  have  opened  an 
authoritative  medical  history.  Nothing  illustrates  so 
well  the  expression  of  the  editors  of  the  ' '  Cambridge 
Modern  History  "  referred  to  more  than  once  in 
these  pages  that  "  in  view  of  changes  and  of  gains 
such  as  these  [the  printing  of  original  documents] 
it  has  become  impossible  for  historical  writers  of  the 
present  day  to  trust  without  reserve  even  to  the  most 
respected  secondary  authority.  The  honest  student 
finds  himself  continually  deserted,  retarded,  misled 
by  the  classics  of  historical  literature. ' '  Fortunately 
for  us  this  sweeping  condemnation  does  not  hold  to 
any  great  extent  for  the  medical  historical  classics. 
All  of  the  classic  historians  of  medicine  tell  us  much 
of  the  surgery  of  the  thirteenth  and  fourteenth  cen- 
turies, and  in  recent  years  the  republication  of  old 
texts  and  the  further  study  of  manuscript  documents 
of  various  kinds  have  made  it  very  clear  that  there 
is  almost  no  period  in  the  history  of  the  world  when 
surgery  was  so  thoroughly  and  successfully  culti- 
vated as  during  the  rise  and  development  of  the  uni- 
versities and  their  medical  schools  in  the  thirteenth 
and  fourteenth  centuries. 

It  is  interesting  to  trace  the  succession  of  great 
contributors  to  surgery  during  these  two  centuries. 
We  know  their  teaching  not  from  tradition,  but  from 
their  text-books  so  faithfully  preserved  for  us  by 
their  devoted  students,  who  must  have  begrudged 
no  time  and  spared  no  labor  in  copying,  for  many  of 
the  books  are  large,  yet  exist  in  many  manuscript 
copies. 


236  OLD-TIME  MAKERS  OF  MEDICINE 

Modern  surgery  may  be  said  to  owe  its  origin  to  a 
school  of  surgeons,  the  leaders  of  whom  were  edu- 
cated at  Salerno  in  the  early  part  of  the  thirteenth 
century,  and  who,  teaching  at  various  north  Italian 
universities,  wrote  out  their  surgical  principles  and 
experiences  in  a  series  of  important  contributions  to 
that  department  of  medical  science.  The  fact  that 
the  origin  of  the  school  was  at  Salerno,  where,  as  is 
well  known,  Arabian  influence  counted  for  much  and 
for  which  Constantine's  translations  of  Arabian 
works  proved  such  a  stimulus  a  century  before, 
makes  most  students  conclude  that  this  later  medie- 
val surgical  development  is  simply  a  continuation  of 
the  Arabian  surgery  that,  as  we  have  seen,  developed 
very  interestingly  during  the  earlier  Middle  Ages. 
Any  such  idea,  however,  is  not  founded  on  the  reali- 
ties of  the  situation,  but  on  an  assumption  with  re- 
gard to  the  extent  of  Arabian  influence.  Gurlt  in  his 
"  History  of  Surgery  "  (Vol.  I,  page  701)  completely 
contradicts  this  idea,  and  says  with  regard  to  the 
first  of  the  great  Italian  writers  on  surgery,  Eogero, 
that  "  though  Arabian  works  on  surgery  had  been 
brought  over  to  Italy  by  Constantine  Africanus  a 
hundred  years  before  Roger's  time,  these  exercised 
no  influence  over  Italian  surgery  in  the  next  century, 
and  there  is  scarcely  a  trace  of  the  surgical  knowl- 
edge of  the  Arabs  to  be  found  in  Roger's  works.' ' 

It  is  in  the  history  of  medicine  particularly  that  it 
is  possible  to  trace  the  true  influence  of  the  Arabs  on 
European  thought  in  the  later  Middle  Ages.  We 
have  already  seen  in  the  chapter  on  Salerno  that 
Arabian  influence  did  harm  to  Salernitan  medical 
teaching.    The  school  of  Salerno  itself  had  developed 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    237 

simple,  dietetic,  hygienic,  and  general  remedial  meas- 
ures that  included  the  use  of  only  a  comparatively 
small  amount  of  drugs.  Its  teachers  emphasized 
nature's  curative  powers.  With  Arabian  influence 
came  polypharmacy,  distrust  of  nature,  and  attempts 
to  cure  disease  rather  than  help  nature.  In  surgery, 
which  developed  very  wonderfully  in  the  thirteenth 
and  fourteenth  centuries,  Salerno  must  be  credited 
with  the  incentive  that  led  up  to  the  marvellous  de- 
velopment that  came.  With  this,  however,  Arabian 
influence  has  nothing  to  do.  Gurlt,  besides  calling 
attention  to  the  fact  that  the  author  of  the  first  great 
text-book  on  the  subject  not  only  did  not  draw  his  in- 
spiration from  Arab  sources,  insisted  that  ' '  instead 
of  any  Arabisms  being  found  in  his  [Roger's]  writ- 
ings many  Grsecisms  occur.' '  The  Salernitan  school 
of  surgery  drank  at  the  fountain-head  of  Greek  sur- 
gery. Apart  from  Greek  sources  Roger's  book  rests 
entirely  upon  his  own  experiences,  those  of  his  teach- 
ers and  his  colleagues,  and  the  tradition  in  surgery 
that  had  developed  at  Salerno.  This  tradition  was 
entirely  from  the  Greek.  Roger  himself  says  in  one 
place,  "  We  have  resolved  to  write  out  deliberately 
our  methods  of  operation  such  as  they  have  been 
derived  from  our  own  experience  and  that  of  our 
colleagues  and  illustrious  men." 


ROGEE,   ROLAND,    AND    THE    FOUR   MASTERS 

Ruggero,  or  Rogero,  who  is  also  known  as  Rogerio 
and  Rogerus  with  the  adjective  Parmensis,  or  Saler- 
nitanus,  of  Parma  or  of  Salerno,  and  often  in  Ger- 
man and  English  history  simply  as  Roger,  lived  at 


238  OLD-TIME  MAKERS  OF  MEDICINE 

the  end  of  the  twelfth  or  the  beginning  of  the  thir- 
teenth century  and  probably  wrote  his  text-book 
about  1180.  This  text-book  was,  according  to  tradi- 
tion, originally  drafted  for  his  lessons  in  surgery  at 
Salerno.  It  attracted  much  attention  and  after  being 
commented  on  by  his  pupil  Eolando,  the  work  of 
both  of  them  being  subsequently  annotated  by  the 
Four  Masters,  this  combined  work  became  the  basis 
of  modern  surgery.  Eoger  was  probably  born  either 
in  Palermo  or  Parma.  There  are  traditions  of  his 
having  taught  for  a  while  at  Paris  and  at  the  Uni- 
versity of  Montpellier,  though  these  are  not  substan- 
tiated. His  book  was  printed  at  Venice  in  1546,  and 
has  been  lately  reprinted  by  De  Eenzi  in  his  "  Col- 
lectio  Salernitana. ' ' 

Eoland  was  a  pupil  of  Eoger's,  and  the  two  names 
that  often  occur  in  medieval  romance  became  asso- 
ciated in  a  great  historic  reality  as  a  consequence  of 
Eoland 's  commentary  on  his  master's  work,  which 
was  a  favorite  text-book  in  surgery  for  a  good  while 
in  the  thirteenth  century  at  Salerno.  Some  space  will 
be  given  to  the  consideration  of  their  surgical  teach- 
ing after  a  few  words  with  regard  to  some  disciples 
who  made  a  second  commentary,  adding  to  the  value 
of  the  original  work. 

This  is  the  well-known  commentary  of  the  Four 
Masters,  a  text-book  of  surgery  written  somewhat  in 
the  way  that  we  now  make  text-books  in  various  de- 
partments of  medicine,  that  is,  by  asking  men  who 
have  made  specialties  of  certain  subjects  to  write  on 
that  subject  and  then  bind  them  all  together  in  a 
single  volume.  It  represents  but  another  striking 
reminder  that  most  of  our  methods  are  old,  not  new 


GBEAT  SUEGEONS  OF  MEDIEVAL  UNIVERSITIES    239 

as  we  are  likely  to  imagine  them.  The  Four  Masters 
took  the  works  of  Roger  and  Rolando,  acknowledged 
their  indebtedness  much  more  completely  than  do  our 
modern  writers  on  all  occasions,  I  fear,  and  added 
their  commentaries. 

Gurlt  says  ("  Geschichte  der  Chirurgie,"  Vol.  I,  p. 
703)  that  "  in  spite  of  the  fact  that  there  is  some 
doubt  about  the  names  of  the  authors,  this  volume 
constitutes  one  of  the  most  important  sources  for  the 
history  of  surgery  of  the  later  Middle  Ages  and 
makes  it  very  clear  that  these  writers  drew  their 
opinions  from  a  rich  experience. ' '  It  is  rather  easy 
to  illustrate  from  the  quotations  given  in  Gurlt  or 
from  the  accounts  of  their  teaching  in  Daremberg  or 
De  Renzi  some  features  of  this  experience  that  can 
scarcely  fail  to  be  surprising  to  modern  surgeons. 
For  instance,  what  is  to  be  found  in  this  old  text- 
book of  surgery  with  regard  to  fractures  of  the  skull 
is  likely  to  be  very  interesting  to  surgeons  at  all 
times.  One  might  be  tempted  to  say  that  fewer  men 
would  die  every  year  in  prison  cells  who  ought  to 
be  in  hospitals,  if  the  old-time  teaching  was  taken  to 
heart.  For  there  are  rather  emphatic  directions  not 
to  conclude  because  the  scalp  is  unwoundedthat  there 
can  be  no  fracture  of  the  skull.  Where  nothing  can 
be  felt  care  must  be  exercised  in  getting  the  history 
of  the  case.  For  instance,  if  a  man  is  hit  by  a  metal 
instrument  shaped  like  the  clapper  of  a  bell  or  by  a 
heavy  key,  or  by  a  rounded  instrument  made  of  lead 
— this  would  remind  one  very  much  of  the  lead  pipe 
of  the  modern  time,  so  fruitful  of  mistakes  of  diag- 
nosis in  head  injuries — special  care  must  be  taken  to 
look  for  symptoms  in  spite  of  the  lack  of  an  external 


240  OLD-TIME  MAKERS  OF  MEDICINE 

penetrating  wound.  Where  there  is  good  reason  to 
suspect  a  fracture  because  of  the  severity  of  the  in- 
jury, the  scalp  should  be  incised  and  a  fracture  of  the 
cranium  looked  for  carefully.  That  is  carrying  the 
exploratory  incision  pretty  far.  If  a  fracture  is 
found  the  surgeon  should  trephine  so  as  to  relieve  the 
brain  of  any  pressure  of  blood  that  might  be  affect- 
ing it. 

There  are  many  warnings,  however,  of  the  danger 
of  opening  the  skull  and  of  the  necessity  for  defi- 
nitely deciding  beforehand  that  there  is  good  reason 
for  so  doing.  How  carefully  their  observations  had 
been  made  and  how  well  they  had  taken  advantage 
of  their  opportunities,  which  were,  of  course,  very 
frequent  in  those  warlike  times  when  firearms  were 
unknown,  hand-to-hand  conflict  common,  and  blunt 
weapons  were  often  used,  can  be  appreciated  very 
well  from  some  of  the  directions.  For  instance,  they 
knew  of  the  possibility  of  fracture  by  contrecoup. 
They  say  that  ' '  quite  frequently  though  the  percus- 
sion comes  in  the  anterior  part  of  the  cranium,  the 
cranium  is  fractured  on  the  opposite  part."  1  They 
even  seem  to  have  known  of  accidents  such  as  we  now 
discuss  in  connection  with  the  laceration  of  the  mid- 
dle meningeal  artery.  They  warn  surgeons  of  the 
possibilities  of  these  cases.  They  tell  the  story  of 
"  a  youth  who  had  a  very  small  wound  made  by  a 
thrown  stone  and  there  seemed  no  serious  results  or 
bad  signs.  He  died  the  next  day,  however.  His 
cranium  was  opened  and  a  large  amount  of  black 

irrhis  is  so  striking  that  I  quote  their  actual  words  from  Gurlt,  p. 
704:  "  Multoties  fit  percussio  in  anteriori  parte  cranei  et  craneum  in 
parte  frangitur  contraria." 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    241 

blood  was  found  coagulated  about  bis  dura 
mater. ' ' 

There  are  many  interesting  tbings  said  witb  re- 
gard to  depressed  fractures  and  tbe  necessity  for 
elevating  tbe  bone.  If  tbe  depressed  portion  is 
wedged  tben  an  opening  sbould  be  made  witb  tbe 
trephine  and  an  elevating  instrument  called  a  spatu- 
men  used  to  relieve  tbe  pressure.  Great  care  sbould 
be  taken,  bowever,  in  carrying  out  this  procedure 
lest  tbe  bone  of  tbe  cranium  itself,  in  being  lifted, 
sbould  injure  tbe  soft  structures  witbin.  Tbe  dura 
mater  sbould  be  carefully  protected  from  injury  as 
well  as  tbe  pia.  Care  sbould  especially  be  exercised 
at  tbe  brow  and  tbe  rear  of  tbe  bead  and  at  tbe  com- 
missures (proram  et  pupim  et  commissural),  since 
at  tbese  points  tbe  dura  mater  is  likely  to  be  ad- 
berent.  Perbaps  tbe  most  striking  expression,  tbe 
word  infect  being  italicized  by  Gurlt,  is :  '  *  In  ele- 
vating tbe  cranium  be  solicitous  lest  you  sbould  infect 
or  injure  tbe  dura  mater. ' ' 

For  wounds  of  tbe  scalp  sutures  of  silk  are  recom- 
mended because  tbis  resists  putrefaction  and  bolds 
tbe  wound  edges  togetber.  Interrupted  sutures 
about  a  finger-breadtb  apart  are  recommended. 
"  Tbe  lower  part  of  tbe  wound  sbould  be  left  open 
so  tbat  tbe  cure  may  proceed  properly.' '  Red  pow- 
der was  strewed  over  tbe  wound  and  the  leaf  of  a 
plant  set  above  it.  In  tbe  lower  angle  of  tbe  wound 
a  pledget  of  lint  for  drainage  purposes  was  inlaid. 
Hemorrhage  was  prevented  by  pressure,  by  the  bind- 
ing on  of  burnt  wool  firmly,  and  by  tbe  ligature  of 
veins  and  by  tbe  cautery. 

Tbere  are  rather  interesting  discussions  of  the 


242  OLD-TIME  MAKERS  OF  MEDICINE 

prognosis  of  wounds  of  the  head,  especially  such  as 
may  be  determined  from  general  symptoms  in  this 
commentary  of  the  Four  Masters  on  Roger's  and 
Rolando's  treatises.  If  an  acute  febrile  condition 
develops,  the  wound  is  mortal.  If  the  patient  loses 
the  use  of  the  hands  and  feet  or  if  he  loses  his  power 
of  direction,  or  his  sensation,  the  wound  is  mortal. 
If  a  universal  paralysis  comes  on,  the  wound  is  mor- 
tal. For  the  treatment  of  all  these  wounds  careful 
precautions  are  suggested.  Cold  was  supposed  to  be 
particularly  noxious  to  them.  Operations  on  the 
head  were  not  to  be  done  in  cold  weather  and,  above 
all,  not  in  cold  places.  The  air  where  such  operations 
were  done  must  be  warmed  artificially.  Hot  plates 
should  surround  the  patient's  head  while  the  opera- 
tion was  being  performed.  If  this  were  not  possible 
they  were  to  be  done  by  candlelight,  the  candle  being 
held  as  close  as  possible  in  a  warm  room.  These 
precautions  are  interesting  as  foreshadowing  many 
ideas  of  much  more  modern  time  and  especially  indi- 
cating how  old  is  the  idea  that  cold  may  be  taken  in 
wounds.  In  popular  medicine  this  still  has  its  place. 
Whenever  a  wound  does  badly  in  the  winter  time  pa- 
tients are  sure  that  they  have  taken  cold.  Such  popu- 
lar medical  ideas  are  always  derived  from  sup- 
posedly scientific  medicine,  and  until  we  learned 
about  microbes  physicians  used  the  same  expressions. 
We  have  not  got  entirely  away  from  them  yet. 

These  old  surgeons  must  have  had  many  experi- 
ences with  fractures  at  the  base  of  the  skull.  Hemor- 
rhages from  the  mouth  and  nose,  for  instance,  and 
from  the  ears  were  considered  bad  signs.  They  were 
inclined  to  suggest  that  openings  into  the  skull  should 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    243 

be  discovered  by  efforts  to  demonstrate  a  connection 
between  the  mouth  and  nares  and  the  brain  cavity. 
For  instance,  in  their  commentary  the  Four  Masters 
said:  "  Let  the  patient  hold  his  mouth  and  nostrils 
tight  shut  and  blow  strongly."  If  there  was  any 
lessening  of  the  pressure  or  any  appearance  of  air 
in  the  wound  in  the  scalp,  then  a  connection  between 
the  mouth  and  nose  was  diagnosticated.  This  is  in- 
genious but  eminently  dangerous  because  of  the  in- 
fectious material  contained  in  the  nasal  and  oral 
cavities,  so  likely  to  be  forced  by  such  pressure  into 
the  skull.  They  were  particularly  anxious  to  detect 
linear  fractures.  One  of  their  methods  of  negative 
diagnosis  for  fractures  of  the  skull  was  that  if  the 
patient  were  able  to  bring  his  teeth  together  strongly, 
or  to  crack  a  nut  without  pain,  then  there  was  no 
fracture  present.  One  of  the  commentators,  how- 
ever, adds  to  this  "  sed  hoc  aliquando  fallit — but  this 
sign  sometimes  fails. ' '  Split  or  crack  fractures  were 
also  diagnosticated  by  the  method  suggested  by  Hip- 
pocrates of  pouring  some  colored  fluid  over  the  skull 
after  the  bone  was  exposed,  when  the  linear  fracture 
would  show  by  coloration.  The  Four  Masters  sug- 
gest a  sort  of  red  ink  for  this  purpose. 

While  they  have  so  much  to  say  about  fractures 
of  the  skull  and  insist,  over  and  over  again,  that 
though  all  depressed  fractures  need  treatment  and 
many  fissure  fractures  require  trepanation,  still 
great  care  must  be  exercised  in  the  selection  of  cases. 
They  say,  for  instance,  that  surgeons  who  in  every 
serious  wound  of  the  head  have  recourse  to  the 
trephine  must  be  looked  upon  as  ' '  fools  and  idiots  ' ' 
(idioti  et  stolidi).    In  the  light  of  what  we  now  know 


% 


244  OLD-TIME  MAKERS  OF  MEDICINE 

about  the  necessity  for  absolute  cleanliness, — asep- 
sis as  we  have  come  to  call  it, — it  is  rather  startling 
to  note  the  directions  that  are  given  to  a  surgeon  to 
be  observed  on  the  day  when  he  is  to  do  a  trepana- 
tion. For  obvious  reasons  I  prefer  to  quote  it  in  the 
Latin:  "  Et  nota  quod  die  ilia  cavendum  est  medico  a 
coitu  et  malis  cibis  aera  corrumpentibus,  ut  sunt 
allia,  cepe,  et  hujusmodi,  et  colloquio  mulieris  men- 
struosce,  et  mcmus  ejus  debent  esse  mundce,  etc." 
My  quotation  is  from  Gurlt,  Vol.  I,  p.  707.  The  direc- 
tions are  most  interesting.  The  surgeon 's  hands  must 
be  clean,  he  must  avoid  the  taking  of  food  that  may 
corrupt  the  air,  such  as  onions,  leeks,  and  the  like; 
must  avoid  menstruating  and  other  women,  and  in 
general  must  keep  himself  in  a  state  of  absolute 
cleanliness. 

To  read  a  passage  like  this  separated  from  its 
context  and  without  knowing  anything  about  the 
wonderful  powers  of  observation  of  the  men  from 
whom  it  comes,  it  would  be  very  easy  to  think  that 
it  is  merely  a  set  of  general  directions  which  they 
had  made  on  some  general  principle,  perhaps  quite 
foolish  in  itself.  We  know,  however,  that  these  men 
had  by  observation  detected  nearly  every  feature  of 
importance  in  fractures  of  the  skull,  their  indications 
and  contra-indications  for  operation  and  their  prog- 
nosis. They  had  anticipated  nearly  everything  of 
importance  that  has  come  to  be  insisted  on  even  in 
our  own  time  in  the  handling  of  these  difficult  cases. 
It  is  not  unlikely,  therefore,  that  they  had  also  ar- 
rived at  the  recognition  by  observations  on  many 
patients  that  the  satisfactory  after-course  of  these 
cases  which  were  operated  on  by  the  surgeon  after 


GBEAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    245 

due  regard  to  such  meticulous  cleanliness  as  is  sug- 
gested in  the  paragraph  I  have  quoted,  made  it  very 
clear  that  these  aseptic  precautions,  as  we  would 
call  them,  were  extremely  important  for  the  outcome 
of  the  case  and,  therefore,  were  well  worth  the  sur- 
geon's attention,  though  they  must  have  required 
very  careful  precautions  and  considerable  self-denial. 
Indeed  this  whole  subject,  the  virtual  anticipation  of 
our  nineteenth-century  principles  of  aseptic  surgery 
in  the  thirteenth  century,  is  not  a  dream  nor  a  far- 
fetched explanation  when  one  knows  enough  about 
the  directions  that  were  laid  down  in  the  surgical 
text-books  of  that  time. 


THE  NOKTH  ITALIAN  SUEGEONS 

After  Roger  and  Rolando  and  the  Four  Masters, 
who  owe  the  inspiration  for  their  work  to  Salerno 
and  the  south  of  Italy,  comes  a  group  of  north 
Italian  surgeons:  Bruno  da  Longoburgo,  usually 
called  simply  Bruno ;  Theodoric  and  his  father,  Hugo 
of  Lucca,  and  William  of  Salicet.  Immediately  fol- 
lowing them  come  two  names  that  belong,  one  almost 
feels,  to  a  more  modern  period :  Mondino,  the  author 
of  the  first  text-book  on  dissection,  and  Lanfranc  (the 
disciple  of  William  of  Salicet),  who  taught  at  Paris 
and  i  l  gave  that  primacy  to  French  surgery  which  it 
maintained  all  the  centuries  down  to  the  nineteenth  " 
(Pagel).  It  might  very  well  be  thought  that /this 
group  of  Italian  surgeons  had  very  little  in  their 
writings  that  would  be  of  any  more  than  antiquarian 
interest  for  the  modern  time.  It  needs  but  a  little 
knowledge  of  their  writings  as  they  have  come  down 


246  OLD-TIME  MAKERS  OF  MEDICINE 

to  us  to  show  how  utterly  false  any  such  opinion  is. 
To  Hugo  da  Lucca  and  his  son  Theodoric  we  owe 
the  introduction  and  the  gradual  bringing  into  prac- 
tical use  of  various  methods  of  anaesthesia.  They 
used  opium  and  mandragora  for  this  purpose  and 
later  employed  an  inhalant  mixture,  the  composition 
of  which  is  not  absolutely  known.  They  seem,  how- 
ever, to  have  been  very  successful  in  producing  in- 
sensibility to  pain  for  even  rather  serious  and  com- 
plicated and  somewhat  lengthy  operations.  Indeed 
it  is  to  this  that  must  be  attributed  most  of  their 
surprising  success  as  surgeons  at  this  early  date. 

We  are  so  accustomed  to  think  that  anaesthesia  was 
discovered  about  the  middle  of  the  nineteenth  cen- 
tury in  America  that  we  forget  that  literature  is 
full  of  references  in  Tom  Middleton's  (seventeenth 
century)  phrase  to  "  the  mercies  of  old  surgeons  who 
put  their  patients  to  sleep  before  they  cut  them." 
Anaesthetics  were  experimented  with  almost  as  zeal- 
ously, during  the  latter  half  of  the  thirteenth  century 
at  least,  as  during  the  latter  half  of  the  nineteenth 
century.  They  were  probably  not  as  successful  as  we 
are, but  they  did  succeed  in  producing  insensibility  to 
pain,  otherwise  they  could  never  have  operated  to  the 
extent  they  did.  Moreover  the  traditions  show  that 
the  Da  Luccas  particularly  had  invented  a  method 
that  left  very  little  to  be  desired  in  this  matter  of 
anaesthesia.  A  reference  to  the  sketch  of  Guy  de 
Chauliac  in  this  volume  will  show  how  practical  the 
method  was  in  his  time. 

Nearly  the  same  story  as  with  regard  to  anaesthet- 
ics has  to  be  repeated  for  what  are  deemed  so  surely 
modern  developments, — asepsis  and  antisepsis.    I 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    247 

have  already  suggested  that  Roger  seems  to  have 
known  how  extremely  important  it  was  to  approach 
operations  upon  the  skull  with  the  most  absolute 
cleanliness.  There  are  many  hints  of  the  same  kind 
in  other  writers  which  show  that  this  was  no  mere 
accidental  remark,  but  was  a  definite  conclusion  de- 
rived from  experience  and  careful  observation  of 
results.  We  find  much  more  with  regard  to  this  same 
subject  in  the  writings  of  the  group  of  northern  Ital- 
ian surgeons  and  especially  in  the  group  of  those 
associated  with  William  of  Salicet.  Professor  Clif- 
ford Allbutt,  Regius  Professor  of  Medicine  at  the 
University  of  Cambridge,  England,  in  his  address 
before  the  St.  Louis  World's  Fair  Congress  of  Arts 
and  Science  in  1904,  did  not  hesitate  to  declare  that 
William  discussed  the  causes  for  union  by  first  in- 
tention and  the  modes  by  which  it  might  be  obtained. 
He,  too,  insisted  on  cleanliness  as  the  most  impor- 
tant factor  in  having  good  surgical  results,  and  all 
of  this  group  of  men,  in  operating  upon  septic  cases, 
used  stronger  wine  as  a  dressing.  This  exerted,  as 
will  be  readily  understood,  a  very  definite  antiseptic 
quality. 

Evidently  some  details  of  the  teaching  of  this 
group  of  great  surgeons  in  northern  Italy  in  the 
second  half  of  the  thirteenth  century  will  make 
clearer  to  us  how  much  the  rising  universities  of  the 
time  were  accomplishing  in  medicine  and  surgery  as 
well  as  in  their  other  departments.  The  dates  of 
the  origin  of  some  of  these  universities  should  per- 
haps be  recalled  so  as  to  remind  readers  how  closely 
related  they  are  to  this  great  group  of  surgical  teach- 
ers.   Salerno  was  founded  very  early,  probably  in 


248  OLD-TIME  MAKERS  OF  MEDICINE 

the  tenth  century;  Bologna,  Reggio,  and  Modena 
came  into  existence  toward  the  end  of  the  twelfth 
century;  Vicenza,  Padua,  Naples,  Vercelli,  and  Pi- 
acenza,  as  well  as  Arezzo,  during  the  first  half  of  the 
thirteenth  century;  Rome,  Perugia,  Trevizo,  Pisa, 
Florence,  Sienna,  Lucca,  Pavia,  and  Ferrara  during 
the  next  century.  The  thirteenth  century  was  the 
special  flourishing  period  of  the  universities,  and 
the  medical  departments,  far  from  being  behind, 
were  leaders  in  accomplishment.  (See  my  "  The 
Thirteenth  Greatest  of  Centuries,"  N.  Y.,  1908.) 

BRUNO  DA  LONGOBURGO 

The  first  of  this  important  group  of  north  Italian 
surgeons  who  taught  at  these  universities  was  Bruno 
of  Longoburgo.  While  he  was  born  in  Calabria,  and 
probably  studied  in  Salerno,  his  work  was  done  at 
Vicenza,  Padua,  and  Verona.  His  text-book,  the 
"  Chirurgia  Magna/ '  dedicated  to  his  friend  An- 
drew of  Piacenza,  was  completed  at  Padua  in  Jan- 
uary, 1252.  Gurlt  notes  that  he  is  the  first  of  the 
Italian  surgeons  who  quotes,  besides  the  Greeks,  the 
Arabian  writers  on  surgery.  Eclecticism  had  defi- 
nitely come  into  vogue  to  replace  exclusive  devotion 
to  the  Greek  authors,  and  men  were  taking  what 
was  good  wherever  they  found  it.  Gurlt  tells  us  that 
Bruno  owed  much  of  what  he  wrote  to  his  own  ex- 
perience and  observation.  He  begins  his  work  by  a 
definition  of  surgery,  chirurgia,  tracing  it  to  the 
Greek  and  emphasizing  that  it  means  handwork.  He 
then  declares  that  it  is  the  last  instrument  of  medi- 
cine to  be  used  only  when  the  other  two  instruments, 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES   249 

diet  and  potions,  have  failed.  He  insists  that  sur- 
geons must  learn  by  seeing  surgical  operations  and 
watching  them  long  and  diligently.  They  must  be 
neither  rash  nor  over  bold  and  should  be  extremely 
cautious  about  operating.  While  he  says  that  he 
does  not  object  to  a  surgeon  taking  a  glass  of  wine, 
the  followers  of  this  specialty  must  not  drink  to 
such  an  extent  as  to  disturb  their  command  over 
themselves,  and  they  must  not  be  habitual  drinkers. 
While  all  that  is  necessary  for  their  art  cannot  be 
learned  out  of  books,  they  must  not  despise  books 
however,  for  many  things  can  be  learned  readily 
from  books,  even  about  the  most  difficult  parts  of 
surgery.  Three  things  the  surgeon  has  to  do : — ' '  to 
bring  together  separated  parts,  to  separate  those 
that  have  become  abnormally  united,  and  to  extirpate 
what  is  superfluous. ' ' 

In  his  second  chapter  on  healing  he  talks  about 
healing  by  first  and  second  intention.  Wounds  must 
be  more  carefully  looked  to  in  summer  than  in  win- 
ter, because  putref 'actio  est  major  in  aestate  quam 
in  hyeme,  putrefaction  is  greater  in  summer  than  in 
winter.  For  proper  union  care  must  be  exercised  to 
bring  the  wound  edges  accurately  together  and  not 
allow  hair,  or  oil,  or  dressings  to  come  between 
them.  In  large  wounds  he  considers  stitching  indis- 
pensable, and  recommends  for  this  a  fine,  square 
needle.  The  preferable  suture  material  in  his  experi- 
ence was  silk  or  linen. 

The  end  of  the  wound  was  to  remain  open  in  order 
that  lint  might  be  placed  therein  in  order  to  draw 
off  any  objectionable  material.  He  is  particularly 
insistent  on  the  necessity  for  drainage.     In  deep 


250  OLD-TIME  MAKERS  OP  MEDICINE 

wounds  special  provision  must  be  made,  and  in 
wounds  of  extremities  the  limb  must  be  so  placed 
as  to  encourage  drainage.  If  drainage  does  not  take 
place,  then  either  the  wound  must  be  thoroughly 
opened,  or  if  necessary  a  counter  opening  must  be 
made  to  provide  drainage.  All  his  treatment  of 
wounds  is  dry,  however.  Water,  he  considered,  al- 
ways did  harm.  We  can  readily  understand  that  the 
water  generally  available  and  especially  as  surgeons 
saw  it  in  camps  and  on  the  battlefield,  was  likely  to 
do  much  more  harm  than  good.  In  penetrating 
wounds  of  the  belly  cavity,  if  there  was  difficulty 
in  bringing  about  the  reposition  of  the  intestines, 
they  were  first  to  be  pressed  back  with  a  sponge 
soaked  in  warm  wine.  Other  manipulations  are  sug- 
gested, and  if  necessary  the  wound  must  be  enlarged. 
If  the  omentum  finds  its  way  out  of  the  wound,  all 
of  it  that  is  black  or  green  must  be  cut  off.  In 
cases  where  the  intestines  are  wounded  they  are  to 
be  sewed  with  a  small  needle  and  a  silk  thread  and 
care  is  to  be  exercised  in  bringing  about  complete 
closure  of  the  wound.  This  much  will  give  a  good 
idea  of  Bruno's  thoroughness.  Altogether,  Gurlt, 
in  his  "  History  of  Surgery,"  gives  about  fifteen 
large  octavo  pages  of  rather  small  type  to  a  brief 
compendium  of  Bruno's  teachings. 

One  or  two  other  remarks  of  Bruno  are  rather 
interesting  in  the  light  of  modern  developments  in 
medicine.  For  instance,  he  suggests  the  possibility 
of  being  able  to  feel  a  stone  in  the  bladder  by  means 
of  bimanual  palpation.  He  teaches  that  mothers 
may  often  be  able  to  cure  hernias,  both  umbilical  and 
inguinal,  in  children  by  promptly  taking  up  the  treat- 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    251 

ment  of  them  as  soon  as  noticed,  bringing  the  edges 
of  the  hernial  opening  together  by  bandages  and 
then  preventing  the  reopening  of  the  hernia  by  pro- 
hibiting wrestling  and  loud  crying  and  violent  mo- 
tion. He  has  seen  overgrowth  of  the  mamma  in 
men,  and  declares  that  it  is  due  to  nothing  else  but 
fat,  as  a  rule.  He  suggests  if  it  should  hang  down 
and  be  in  the  way  on  account  of  its  size  it  should 
be  extirpated.  He  seems  to  have  known  considera- 
ble about  the  lipomas  and  advises  that  they  need 
only  be  removed  in  case  they  become  bothersomely 
large.  The  removal  is  easy,  and  any  bleeding  that 
takes  place  may  be  stopped  by  means  of  the  cautery. 
He  divides  rectal  fistulas  into  penetrating  and  non- 
penetrating, and  suggests  salves  for  the  non-pene- 
trating and  the  actual  cautery  for  those  that  pene- 
trate. He  warns  against  the  possibility  of  producing 
incontinence  by  the  incision  of  deep  fistulas,  for  this 
would  leave  the  patient  in  a  worse  state  than  before. 

HUGH  OF  LUCCA 

Bruno  brought  up  with  him  the  methods  and  prin- 
ciples of  surgery  from  the  south  of  Italy,  but  there 
seems  to  have  been  already  in  the  north  at  least  one 
distinguished  surgeon  who  had  made  his  mark.  This 
was  Ugo  da  Lucca  or  Ugo  Luccanus,  sometimes 
known  in  the  modern  times  in  German  histories  of 
medicine  as  Hugo  da  Lucca  and  in  English,  Hugh  of 
Lucca.  He  flourished  early  in  the  thirteenth  cen- 
tury. In  1214  he  was  called  to  Bologna  to  become 
the  city  physician,  and  joined  the  Bolognese  volun- 
teers in  the  crusade  in  1218,  being  present  at  the 


252  OLD-TIME  MAKEES  OF  MEDICINE 

siege  of  Damietta.  He  returned  to  Bologna  in  1221 
and  was  given  the  post  of  legal  physician  to  the  city. 
The  civic  statutes  of  Bologna  are,  according  to  G-urlt, 
the  oldest  monument  of  legal  medicine  in  the  Middle 
Ages.  Ugo  died  not  long  after  the  middle  of  the 
century,  and  is  said  to  have  been  nearly  one  hundred 
years  old.  Of  his  five  sons,  three  became  physicians. 
The  most  celebrated  of  these  was  Theodoric,  who 
wrote  a  text -book  of  surgery  in  which  are  set  down 
the  traditions  of  surgery  that  had  been  practised  in 
his  father 's  life.  Theodoric  is  especially  enthusiastic 
in  praise  of  his  father,  because  he  succeeded  in  bring- 
ing about  such  perfect  healing  of  wounds  with  only 
wine  and  water  and  the  ligature  and  without  the 
employment  of  any  ointments. 

Ugo  seems  to  have  occupied  himself  much  with 
chemistry.  To  him  we  owe  a  series  of  discoveries 
with  regard  to  anodyne  and  anaesthetizing  drugs. 
He  is  said  to  have  been  the  first  who  taught  the 
sublimation  of  arsenic.  Unfortunately  he  left  no 
writings  after  him,  and  all  that  we  know  of  him  we 
owe  to  the  filial  devotion  of  his  son  Theodoric. 


THEODORIC 

This  son,  after  having  completed  his  medical 
studies  at  the  age  of  about  twenty-three,  en- 
tered the  Dominican  Order,  then  only  recently 
established,  but  continued  his  practice  of  medi- 
cine undisturbed.  His  ecclesiastical  preferment 
was  rapid.  He  attracted  the  attention  of  the 
Bishop  of  Valencia,  and  became  his  chaplain 
in  Eome.    At  the  age  of  about  fifty  he  was  made 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES   253 

a  bishop  in  South  Italy  and  later  transferred 
to  the  Bishopric  of  Cervia,  not  far  from  Ravenna. 
Most  of  his  life  seems  to  have  been  passed  in  Bo- 
logna however,  and  he  continued  to  practise  medi- 
cine, devoting  his  fees,  however,  entirely  to  charity. 
His  text-book  of  surgery  was  written  about  1266 
and  is  signed  with  his  full  name  and  title  as  Bishop 
of  Cervia.  Even  at  this  time  however,  he  still  re- 
tained the  custom  of  designating  himself  as  a  mem- 
ber of  the  Dominican  Order. 

The  most  interesting  thing  in  the  first  book  of 
his  surgery  is  undoubtedly  his  declaration  that  all 
wounds  should  be  treated  only  with  wine  and  ban- 
daging. Wine  he  insists  on  as  the  best  possible 
dressing  for  wounds.  It  was  the  most  readily  availa- 
ble antiseptic  that  they  had  at  that  time,  and  un- 
doubtedly both  his  father's  recommendation  of  it  and 
his  own  favorable  experience  with  it  were  due  to 
this  quality.  It  must  have  acted  as  an  excellent  in- 
hibitive  agent  of  many  of  the  simple  forms  of  pus 
formation.  At  the  conclusion  of  this  first  book  he 
emphasizes  that  it  is  extremely  important  for  the 
healing  of  wounds  that  the  patient  should  have  good 
blood,  and  this  can  only  be  obtained  from  suitable 
nutrition.  It  is  essential  therefore  for  the  physician 
to  be  familiar  with  the  foods  which  produce  good 
blood  in  order  that  his  wounded  patients  may  be  fed 
appropriately.  He  suggests,  then,  a  number  of  arti- 
cles of  diet  which  are  particularly  useful  in  produc- 
ing such  a  favorable  state  of  the  tissues  as  will  bring 
about  the  rebirth  of  flesh  and  the  adhesion  of  wound 
surfaces.  Shortly  before  he  emphasizes  the  neces- 
sity for  not  injuring  nerves,  though  if  nerves  have 


254:  OLD-TIME  MAKERS  OF  MEDICINE 

been  cut  they  should  be  brought  together  as  carefully 
as  possible,  the  wound  edges  being  then  approxi- 
mated. 

Probably  the  most  interesting  feature  for  our  gen- 
eration of  the  great  text-books  of  the  surgeons  of 
the  medieval  universities  is  the  occurrence  in  them 
of  definite  directions  for  securing  union  in  surgical 
wounds,  at  least  by  first  intention  and  their  insist- 
ence on  keeping  wounds  clear.  The  expression 
union  by  first  intention  comes  to  us  from  the  olden 
time.  They  even  boasted  that  the  scars  left  after 
their  incisions  were  often  so  small  as  to  be  scarcely 
noticeable.  Such  expressions  of  course  could  only 
have  come  from  men  who  had  succeeded  in  solving 
some  of  the  problems  of  antisepsis  that  were  solved 
once  more  in  the  generation  preceding  our  own. 
With  regard  to  their  treatment  of  wounds,  Professor 
Clifford  Allbutt  says : * 

i '  They  washed  the  wound  with  wine,  scrupulously 
removing  every  foreign  particle ;  then  they  brought 
the  edges  together,  not  allowing  wine  nor  anything 
else  to  remain  within — dry  adhesive  surfaces  were 
their  desire.  Nature,  they  said,  produces  the  means 
of  union  in  a  viscous  exudation,  or  natural  balm,  as 
it  was  afterwards  called  by  Paracelsus,  Pare,  and 
Wurtz.  In  older  wounds  they  did  their  best  to  ob- 
tain union  by  cleansing,  desiccation,  and  refreshing 
of  the  edges.  Upon  the  outer  surface  they  laid  only 
lint  steeped  in  wine.  Powders  they  regarded  as  too 
desiccating,  for  powder  shuts  in  decomposing  mat- 
ters ;  wine  after  washing,  purifying,  and  drying  the 
raw  surfaces  evaporates. 


>? 


J"  Historical  Relations  of  Medicine  and  Surgery  Down  to  the  Six- 
teenth Century,"  London,  1904. 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    255 


Theodoric  comes  nearest  to  us^efsall  these  old  sur- 
Cgeons.  The  surgeon  who  in  d26§JwYote :  ' '  For  it 
is  not  necessary,  as  Roger  and  Roland  have  written, 
as  many  of  their  disciples  teach,  and  as  all  modern 
surgeons  profess,  that  pus  should  be  generated  in 
wounds.  No  error  can  be  greater  than  this.  Such 
a  practice  is  indeed  to  hinder  nature,  to  prolong  the 
disease,  and  to  prevent  the  conglutination  and  con- 
solidation of  the  wound  ' '  was  more  than  half  a  mil- 
lennium ahead  of  his  time.  The  italics  in  the  word 
modern  are  mine,  but  might  well  have  been  used  by 
some  early  advocate  of  antisepsis  or  even  by  Lord 
Lister  himself.  Just  six  centuries  almost  to  the  year 
would  separate  the  two  declarations,  yet  they 
would  be  just  as  true  at  one  time  as  at  another. 
When  we  learn  that  Theodoric  was  proud  of  the 
beautiful  cicatrices  which  he  obtained  without  the 
use  of  any  ointment,  pulcherrimas  cicatrices  sine 
unguento  attquo  inducebat,  then  further  that  he  im- 
pugned the  use  of  poultices  and  of  oils  on  wounds, 
while  powders  were  too  drying  and  besides  had  a 
tendency  to  prevent  drainage,  the  literal  meaning  of 
the  Latin  words  saniem  incarcerare  is  to  "  in- 
carcerate sanious  material,"  it  is  easy  to  understand 
that  the  claim  that  antiseptic  surgery  was  antici- 
pated six  centuries  ago  is  no  exaggeration  and  no 
far-fetched  explanation  with  modern  ideas  in  mind 
of  certain  clever  modes  of  dressing  hit  upon  acci- 
dentally by  medieval  surgeons. 

Theodoric's  treatment  of  many  practical  problems 
is  interesting  for  the  modern  time.  For  instance,  in 
his  discussion  of  cancer  he  says  that  there  are  two 
forms  of  the  affection.     One  of  them  is  due  to  a 


256  OLD-TIME  MAKERS  OF  MEDICINE 

melancholy  humor,  a  constitutional  tendency  as  it 
were,  and  occurs  especially  in  the  breasts  of  women 
or  latent  in  the  womb.  This  is  difficult  of  treatment 
and  usually  fatal.  The  other  class  consists  of  a 
deep  ulcer  with  undermined  edges,  occurring  partic- 
ularly on  the  legs,  difficult  to  cure  and  ready  of  re- 
lapse, but  for  which  the  outlook  is  not  so  bad.  His 
description  of  noli  me  tang  ere  and  of  lupus  is  rather 
practical.  Lupus  is  ' i  eating  herpes, ' '  occurs  mainly 
on  the  nose,  or  around  the  mouth,  slowly  increases, 
and  either  follows  a  preceding  erysipelas  or  comes 
from  some  internal  cause.  Noli  me  tangere  is  a  cor- 
roding ulcer,  so  called  perhaps  because  irritation  of 
it  causes  it  to  spread  more  rapidly.  He  thinks  that 
deep  cauterization  of  it  is  the  best  treatment.  Since 
these  are  in  the  department  of  skin  diseases  this 
seems  the  place  to  mention  that  Theodoric  describes 
salivation  as  occurring  after  the  use  of  mercury  for 
certain  skin  diseases.  He  has  already  shown  that 
he  knows  of  certain  genital  ulcers  and  sores  on  the 
genital  regions  and  of  distinctions  between  them. 

WILLIAM   OF   SALICET 

The  third  of  the  great  surgeons  in  northern  Italy 
was  William  of  Salicet.  He  was  a  pupil  of  Bruno's 
and  the  master  of  Lanfranc.  The  first  part  of  his 
life  was  passed  at  Bologna  and  the  latter  part  as  the 
municipal  and  hospital  physician  of  Verona.  He 
probably  died  about  1280.  He  was  a  physician  as 
well  as  a  surgeon  and  was  one  of  those  who  insisted 
that  the  two  modes  of  practising  medicine  should  not 
be  separated,  or  if  they  were  both  medicine  and 


GBEAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    257 

surgery  would  suffer.  He  thought  that  the  physician 
learned  much  by  seeing  the  interior  of  the  body  dur- 
ing life,  while  the  surgeon  was  more  conservative 
if  he  were  a  physician.  It  is  curiously  interesting 
to  find  that  the  Regius  Professors  at  both  Oxford 
and  Cambridge  in  our  time  have  expressed  them- 
selves somewhat  similarly.  Professor  Clifford  All- 
butt  is  quite  emphatic  in  this  matter  and  Professor 
Osier  is  on  record  to  the  same  effect.  Following 
Theodoric,  William  of  Salicet  did  much  to  get  away 
from  the  Arabic  abuse  of  the  cautery  and  brought 
the  knife  back  to  its  proper  place  again  as  the  ideal 
surgical  instrument.  Unlike  those  who  had  written 
before  him,  William  quoted  very  little  from  preced- 
ing writers.  Whenever  he  quotes  his  contemporaries 
it  is  in  order  to  criticise  them.  He  depended  on  his 
own  experience  and  considered  that  it  was  only  what 
he  had  actually  learned  from  experience  that  he 
should  publish  for  the  benefit  of  others. 

A  very  good  idea  of  the  sort  of  surgery  that  Wil- 
liam of  Salicet  practised  may  be  obtained  even  from 
the  beginning  of  the  first  chapter  of  his  first  book. 
This  is  all  with  regard  to  surgery  of  the  head.  He 
begins  with  the  treatment  of  hydrocephalus  or,  as 
he  calls  it, ' '  water  collected  in  the  heads  of  children 
newly  born."  He  rejects  opening  of  the  head  by  an 
incision  because  of  the  danger  of  it.  In  a  number  of 
cases,  however,  he  had  had  success  by  puncturing  the 
scalp  and  membranes  with  a  cautery,  though  but  a 
very  small  opening  was  made  and  the  fluid  was  al- 
lowed to  escape  only  drop  by  drop.  He  then  takes  up 
eye  diseases,  a  department  of  surgery  rather  well 
developed  at  that  time,  as  can  be  seen  from  our 


258  OLD-TIME  MAKERS  OF  MEDICINE 

account  of  the  work  of  Pope  John  XXI  as  an  oph- 
thalmologist during  the  thirteenth  century.  See 
Ophthalmology  (January,  1909),  reprinted  in 
"  Catholic  Churchmen  in  Science,"  Philadelphia, 
The  Dolphin  Press,  1909. 

William  devotes  six  chapters  to  the  diseases  of 
the  eyes  and  the  eyelids.  Then  there  are  two  chap- 
ters on  affections  of  the  ears.  Foreign  bodies  and 
an  accumulation  of  ear  wax  are  removed  by  means 
of  instruments.  A  polyp  is  either  cut  off  or  its  pedi- 
cle bound  with  a  ligature,  and  it  is  allowed  to  shrivel. 
The  next  chapter  is  on  the  nose.  Nasal  polyps  were 
to  be  grasped  with  a  sharp  tenaculum,  cum  tenacillis 
acutis,  and  either  wholly  or  partially  extracted. 
Eanula  was  treated  by  being  lifted  well  forward  by 
means  of  a  sharp  iron  hook  and  then  split  with  a 
razor.  It  is  evident  that  the  tendency  of  these  to  fill 
up  again  was  recognized,  and  accordingly  it  was 
recommended  that  vitriol  powder,  or  alum  with  salt, 
be  placed  in  the  cavity  for  a  time  after  evacuation 
in  order  to  produce  adhesive  inflammation. 

In  the  same  chapter  on  the  mouth  one  finds  that 
William  did  not  hesitate  to  perform  what  cannot  but 
be  considered  rather  extensive  operations  within 
the  oral  cavity.  For  instance,  he  tells  of  removing 
a  large  epulis  and  gives  an  account  in  detail  of  the 
case.  To  quote  his  own  words :  ' ■  I  cured  a  certain 
woman  from  Piacenza  who  was  suffering  from  fleshy 
tumor  on  the  gums  of  the  upper  jaw,  the  tumor  hav- 
ing grown  to  such  a  size  above  the  teeth  and  the 
gums  that  it  was  as  large  or  perhaps  larger  than  a 
hen's  egg.  I  removed  it  at  four  operations  by 
means    of   heated   iron   instruments.    At   the   last 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    259 

operation  I  removed  the  teeth  that  were  loose  with 
certain  parts  of  the  jawbone.' ' 

In  the  next  chapter  there  is  an  account  of  the  treat- 
ment of  a  remarkable  case  of  abscess  of  the  uvula. 
In  the  following  chapter  the  swelling  of  cervical 
glands  is  taken  up.  In  his  experience  expectant 
treatment  of  these  was  best.  He  advises  internal 
medication  with  the  building  up  of  the  general 
health,  or  suggests  allowing  the  inflamed  glands  to 
empty  themselves  after  pustulation.  After  much 
meddlesome  surgery  we  are  almost  back  to  his  meth- 
ods again.  He  did  not  hesitate  to  treat  goitre  sur- 
gically, though  he  considered  there  were  certain  in- 
ternal remedies  that  would  benefit  it.  In  obstinate 
cases  he  suggests  the  complete  extirpation  of  cystic 
goitre,  but  if  the  sac  is  allowed  to  remain  it  should 
be  thoroughly  rubbed  over  on  the  inside  with  green 
ointment.  He  warns  about  the  necessity  for  avoid- 
ing the  veins  and  arteries  in  this  operation,  and  says 
that  ' '  in  this  affection  many  large  veins  make  their 
appearance  and  they  find  their  way  everywhere 
through  the  fleshy  mass." 

What  I  have  given  here  is  to  be  found  in  a  little 
more  than  half  a  page  of  G-urlt's  abstract  of  the 
first  twenty  chapters  of  Salicet's  first  book.  Alto- 
gether Gurlt  has  more  than  ten  pages  of  rather  small 
print  with  regard  to  William ;  most  of  it  is  as  inter- 
esting and  as  practical  and  as  representative  of  an- 
ticipations of  what  is  done  in  the  modern  time  as 
what  I  have  here  quoted.  William,  as  I  have  said, 
depended  much  more  upon  his  own  experience  than 
upon  what  was  to  be  found  in  text-books.  He  knew 
the  old  text-books  very  well  however,  but  as  a  rule 


260  OLD-TIME  MAKERS  OF  MEDICINE 

did  not  quote  from  them  unless  he  had  tried  the 
recommendations  for  himself,  or  unless  similar  cases 
to  these  mentioned  had  come  under  his  own  observa- 
tion. He  was  evidently  a  thoroughly  observant  phy- 
sician, a  skilled  surgeon  who  was  practical  enough  to 
see  the  simplest  way  to  do  things,  and  he  proceeded 
to  do  them.  It  is  no  wonder  that  he  influenced  suc- 
ceeding generations  so  much,  nor  that  his  great 
pupil,  Lanfranc,  continuing  his  tradition,  founded  a 
school  of  surgery  in  Paris,  the  influence  of  which 
was  to  endure  almost  down  to  our  time,  and  give 
France  a  primacy  in  surgery  until  the  nineteenth 
century. 

LANFRANC 

After  Salicet's  lifetime  the  focus  of  interest  in 
surgery  changes  from  Italy  to  France,  and  what  is 
still  more  complimentary  to  William,  it  is  through  a 
favorite  disciple  of  his  that  the  change  takes  place. 
This  was  Lanfranchi,  or  Lanfranco,  sometimes 
spoken  of  as  Alanfrancus,  who  practised  as  phy- 
sician and  surgeon  in  Milan  until  banished  from 
there  by  Matteo  Visconti  about  1290.  He  then  went 
to  Lyons,  where  in  the  course  of  his  practice  he 
attracted  so  much  attention  that  he  was  offered  the 
opportunity  to  teach  surgery  in  Paris.  He  attracted 
what  Gurlt  calls  an  almost  incredible  number  of 
scholars  to  his  lessons  in  Paris,  and  by  hundreds 
they  accompanied  him  to  the  bedside  of  his  patients 
and  attended  his  operations.  The  dean  of  the  med- 
ical faculty,  Jean  de  Pas  savant,  urged  him  to  write 
a  text-book  of  surgery,  not  only  for  the  benefit  of 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    261 

his  students  at  Paris  but  for  the  sake  of  the  prestige 
which  this  would  confer  on  the  medical  school. 
Deans  still  urge  the  same  reasons  for  writing.  Lan- 
franc  completed  his  surgery,  called  "  Chirurgia 
•Magna, ' '  in  1296,  and  dedicated  it  to  Philippe  le  Bel, 
the  then  reigning  French  King.  Ten  years  later  he 
died,  but  in  the  meantime  he  had  transferred  Italian 
prestige  in  surgery  from  Italy  to  France  and  laid 
the  foundations  in  Paris  of  a  thoroughly  scientific 
as  well  as  a  practical  surgery,  though  this  depart- 
ment of  the  medical  school  had  been  in  a  sadly 
backward  state  when  he  came. 

In  the  second  chapter  of  this  text-book,  the  first 
containing  the  definition  of  surgery  and  general  in- 
troduction, Lanfranc  describes  the  qualities  that  in 
his  opinion  a  surgeon  should  possess.  He  says,  "  It 
is  necessary  that  a  surgeon  should  have  a  temperate 
and  moderate  disposition.  That  he  should  have  well- 
formed  hands,  long  slender  fingers,  a  strong  body, 
not  inclined  to  tremble  and  with  all  his  members 
trained  to  the  capable  fulfilment  of  the  wishes  of 
his  mind.  He  should  be  of  deep  intelligence  and 
of  a  simple,  humble,  brave,  but  not  audacious  dis- 
position. He  should  be  well  grounded  in  natural 
science,  and  should  know  not  only  medicine  but  every 
part  of  philosophy ;  should  know  logic  well,  so  as  to 
be  able  to  understand  what  is  written,  to  talk  prop- 
erly, and  to  support  what  he  has  to  say  by  good  rea- 
sons." He  suggests  that  it  would  be  well  for  the 
surgeon  to  have  spent  some  time  teaching  grammar 
and  dialectics  and  rhetoric,  especially  if  he  is  to 
teach  others  in  surgery,  for  this  practice  will  add 
greatly  to  his  teaching  power.    Some  of  his  expres- 


262  OLD-TIME  MAKERS  OF  MEDICINE 


» 


sions  might  well  be  repeated  to  young  surgeons  in 
the  modern  time.  "  The  surgeon  should  not  love 
difficult  cases  and  should  not  allow  himself  to  be 
tempted  to  undertake  those  that  are  desperate.  He 
should  help  the  poor  as  far  as  he  can,  but  he 
should  not  hesitate  to  ask  for  good  fees  from  the 
rich. ' ' 

Many  generations  since  Lanfranc 's  time  have 
used  the  word  nerves  for  tendons.  Lanfranc,  how- 
ever, made  no  such  mistake.  He  says  that  the 
wounds  of  nerves,  since  the  nerve  is  an  instrument 
of  sense  arTd  motion,  are,  on  account  of  the  greater 
sensitiveness  which  these  structures  possess,  likely 
to  involve  much  pain.  Wounds  along  the  length  of 
the  nerves  are  less  dangerous  than  those  across 
them.  When  a  nerve  is  completely  divided  by  a 
cross  wound  Lanfranc  is  of  the  opinion,  though 
Theodoric  and  some  others  are  opposed  to  it,  that 
the  nerve  ends  should  be  stitched  together.  He  says 
that  this  suture  insures  the  redintegration  of  the 
nerve  much  better.  After  this  operation  the  restora- 
tion of  the  usefulness  of  the  member  is  more  com- 
plete and  assured. 

His  description  of  the  treatment  of  the  bite  of  a 
rabid  dog  is  interesting.  A  large  cupping  glass 
should  be  applied  over  the  wound  so  as  to  draw  out 
as  much  blood  as  possible.  After  this  the  wound 
should  be  dilated  and  thoroughly  cauterized  to  its 
depths  with  a  hot  iron.  It  should  then  be  covered 
with  various  substances  that  were  supposed  to  draw, 
in  order  as  far  as  possible  to  remove  the  poison. 
His  description  of  how  one  may  recognize  a  rabid 
animal  is  rather  striking  in  the  light  of  our  present 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    263 

knowledge,  for  he  seems  to  have  realized  that  the 
main  diagnostic  element  is  a  change  in  the  disposi- 
tion of  the  animal,  but  above  all  a  definite  tendency 
to  lack  playfulness.  Lanfranc  had  seen  a  number 
of  cases  of  true  rabies,  and  describes  and  suggests 
treatment  for  them,  though  evidently  without  very 
much  confidence  in  the  success  of  the  treat- 
ment. 

The  treatment  of  snake  bites  and  the  bites  of  other 
poisonous  animals  was  supposed  to  follow  the  prin- 
ciples laid  down  for  the  bite  of  a  mad  dog,  especially 
as  regards  the  encouragement  of  free  bleeding  and 
the  use  of  the  cautery. 

Lanfranc  has  many  other  expressions  that  one  is 
tempted  to  quote,  because  they  show  a  thinking  sur- 
geon of  the  old  time,  anticipating  many  supposedly 
modern  ideas  and  conclusions.  He  is  a  particular 
favorite  of  Gurlt 's,  who  has  more  than  twenty-five 
large  octavo,  closely  printed  pages  with  regard  to 
him.  There  is  scarcely  any  development  in  our  mod- 
ern surgery  that  Lanfranc  has  not  at  least  a  hint  of, 
certainly  nothing  in  the  surgery  of  a  generation  ago 
that  does  not  find  a  mention  in  his  book.  On  most 
subjects  he  has  practical  observations  from  his  own 
experience  to  add  to  what  was  in  surgical  literature 
before  his  time.  He  quotes  altogether  more  than 
a  score  of  writers  on  surgery  who  had  preceded 
him  and  evidently  was  thoroughly  familiar  with  gen- 
eral surgical  literature.  There  is  scarcely  an  impor- 
tant surgical  topic  on  which  Gurlt  does  not  find  some 
interesting  and  personal  remarks  made  by  Lanfranc. 
All  that  we  can  do  here  is  refer  those  who  are  inter- 
ested in  Lanfranc  to  his  own  works  or  Gurlt. 


264  OLD-TIME  MAKERS  OF  MEDICINE 


MONDEVILLE 

The  next  of  the  important  surgeons  who  were  to 
bring  such  distinction  to  French  surgery  for  five 
centuries  was  Henri  de  Mondeville.  Writers  usu- 
ally quote  him  as  Henricus.  His  latter  name  is  only 
the  place  of  his  birth,  which  was  probably  not  far 
from  Caen  in  Normandy.  It  is  spelled  in  so  many 
different  ways,  however,  by  different  writers  that  it 
is  well  to  realize  that  almost  anything  that  looks 
like  Mondeville  probably  refers  to  him.  Such  vari- 
ants as  Mundeville,  Hermondaville,  Amondaville, 
Amundaville,  Amandaville,  Mandeville,  Armanda- 
ville,  Armendaville,  Amandavilla  occur.  We  owe 
a  large  amount  of  our  information  with  re- 
gard to  him  to  Professor  Pagel,  who  issued  the 
first  edition  of  his  book  ever  published  (Berlin, 
1892).  It  may  seem  surprising  that  Mondeville 's 
work  should  have  been  left  thus  long  without  publica- 
tion, but  unfortunately  he  did  not  live  long  enough  to 
finish  it.  He  was  one  of  the  victims  that  tuberculosis 
claimed  among  physicians  in  the  midst  of  their  work. 
Though  there  are  a  great  number  of  manuscript 
copies  of  his  book,  somehow  Eenaissance  interest  in 
it  in  its  incompleted  state  was  never  aroused  suf- 
ficiently to  bring  about  a  printed  edition.  Certainly 
it  was  not  because  of  any  lack  of  interest  on  the  part 
of  his  contemporaries  or  any  lack  of  significance  in 
the  work  itself,  for  its  printing  has  been  one  of  the 
surprises  afforded  us  in  the  modern  time  as  showing 
how  thoroughly  a  great  writer  on  surgery  did  his 
work  at  the  beginning  of  the  fourteenth  century. 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    265 

Gurlt,  in  his  "  History  of  Surgery/ '  has  given  over 
forty  pages,  much  of  it  small  type,  with  regard  to 
Mondeville,  because  of  the  special  interest  there  is 
in  his  writing.1 

His  life  is  of  particular  interest  for  other  reasons 
besides  his  subsequent  success  as  a  surgeon.  He  was 
another  of  the  university  men  of  this  time  who  wan- 
dered far  for  opportunities  in  education.  Though 
born  in  the  north  of  France  and  receiving  his  pre- 
liminary education  there,  he  made  his  medical  stud- 
ies towards  the  end  of  the  thirteenth  century  under 
Theodoric  in  Italy.  Afterwards  he  studied  medicine 
in  Montpellier  and  surgery  in  Paris.  Later  he  gave 
at  least  one  course  of  lectures  at  Montpellier  himself 
and  a  series  of  lectures  in  Paris,  attracting  to  both 
universities  during  his  professorship  a  crowd  of 
students  from  every  part  of  Europe.  One  of  his 
teachers  at  Paris  had  been  his  compatriot,  Jean 
Pitard,  the  surgeon  of  Philippe  le  Bel,  of  whom  he 
speaks  as  "  most  skilful  and  expert  in  the  art  of 
surgery,' '  and  it  was  doubtless  to  Pitard 's  friend- 
ship that  he  owed  his  appointment  as  one  of  the  four 
surgeons  and  three  physicians  who  accompanied  the 
King  into  Flanders. 

Besides  his  lectures,  Mondeville  had  a  large  con- 
sultant practice  and  also  had  to  accompany  the  King 
on  his  campaigns.    This  made  it  extremely  difficult 

JOf  course,  for  any  extended  knowledge  of  Mondeville,  a  modern 
reader  must  turn  to  Nicaise's  translation  of  his  "Chirurgia,"  which, 
with  an  introduction  and  a  biography,  was  published  at  Paris  in  1893. 
Nicaise's  publication  of  this  and  of  Guy  de  Chauliac's  treatise  has 
worked  a  revolution  in  medical  history  and,  above  all,  has  made 
these  old  authors  available  for  those  who  hesitate  to  take  up  a  work 
written  entirely  in  Latin. 


266  OLD-TIME  MAKERS  OF  MEDICINE 

for  him  to  keep  continuously  at  the  writing  of  his 
book.  It  was  delayed  in  spite  of  his  good  intentions, 
and  we  have  the  picture  that  is  so  familiar  in  the 
modern  time  of  a  busy  man  trying  to  steal  or  make 
time  for  his  writing.  Unfortunately,  in  addition  to 
other  obstacles,  Mondeville  showed  probably  before 
he  was  forty  the  first  symptoms  of  a  serious 
pulmonary  disease,  presumably  tuberculosis.  He 
bravely  fought  it  and  went  on  with  his  work.  As  his 
end  approached  he  sketched  in  lightly  what  he  had 
hoped  to  treat  much  more  formally,  and  then  turned 
to  what  was  to  have  been  the  last  chapter  of  his 
book,  the  Antidotarium  or  suggestions  of  practical 
remedies  against  diseases  of  various  kinds  because 
his  students  and  physician  friends  were  urging  him 
to  complete  this  portion  for  them.  We  of  the  modern 
time  are  much  less  interested  in  that  than  we  would 
have  been  in  some  of  the  portions  of  the  work  that 
Mondeville  neglected  in  order  to  provide  therapeutic 
hints  for  his  disciples.  But  then  the  students  and 
young  physicians  have  always  clamored  for  the 
practical — which  so  far  at  least  in  medical  history 
has  always  proved  of  only  passing  interest. 

It  is  often  said  that  at  this  time  surgery  was 
mainly  in  the  hands  of  barbers  and  the  ignorant. 
Henri  de  Mondeville,  however,  is  a  striking  example 
in  contradiction  of  this.  He  must  have  had  a  fine 
preliminary  education  and  his  book  shows  very  wide 
reading.  There  is  almost  no  one  of  any  importance 
who  seriously  touched  upon  medicine  or  surgery  be- 
fore his  time  whom  Mondeville  does  not  quote.  Hip- 
pocrates, Aristotle,  Dioscorides,  Pliny,  Galen, 
Rhazes,  Ali  Abbas,  Abulcasis,  Avicenna,  Constan- 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    267 

tine  Africanus,  Averroes,  Maimonides,  Albertus 
Magnus,  Hugo  of  Lucca,  Theodoric,  William  of  Sa- 
licet,  Lanfranc  are  all  quoted,  and  not  once  or  twice 
but  many  times.  Besides  lie  has  quotations  from 
the  poets  and  philosophers,  Cato,  Diogenes,  Horace, 
Ovid,  Plato,  Seneca,  and  others.  He  was  a  learned 
man,  devoting  himself  to  surgery. 

It  is  no  wonder,  then,  that  he  thought  that  a  sur- 
geon should  be  a  scholar,  and  that  he  needed  to 
know  much  more  than  a  physician.  One  of  his  char- 
acteristic passages  is  that  in  which  he  declares  "  it 
is  impossible  that  a  surgeon  should  be  expert  who 
does  not  know  not  only  the  principles,  but  every- 
thing worth  while  knowing  about  medicine,"  and 
then  he  added,  "  just  as  it  is  impossible  for  a  man 
to  be  a  good  physician  who  is  entirely  ignorant  of 
the  art  of  surgery. ' '  He  says  further :  ' '  This  our 
art  of  surgery,  which  is  the  third  part  of  medicine 
(the  other  two  parts  were  diet  and  drugs),  is,  with 
all  due  reverence  to  physicians,  considered  by  us 
surgeons  ourselves  and  by  the  non-medical  as  a 
more  certain,  nobler,  securer,  more  perfect,  more 
necessary,  and  more  lucrative  art  than  the  other 
parts  of  medicine."  Surgeons  have  always  been 
prone  to  glory  in  their  specialty. 

Mondeville  had  a  high  idea  of  the  training  that 
a  surgeon  should  possess.  He  says:  "  A  surgeon 
who  wishes  to  operate  regularly  ought  first  for  a 
long  time  to  frequent  places  in  which  skilled  sur- 
geons operate  often,  and  he  ought  to  pay  careful 
attention  to  their  operations  and  commit  their  tech- 
nique to  memory.  Then  he  ought  to  associate  him- 
self with  them  in  doing  operations.    A  man  cannot 


268  OLD-TIME  MAKEBS  OF  MEDICINE 

be  a  good  surgeon  unless  he  knows  both  the  art  and 
science  of  medicine  and  especially  anatomy.  The 
characteristics  of  a  good  surgeon  are  that  he  should 
be  moderately  bold,  not  given  to  disputations  before 
those  who  do  not  know  medicine,  operate  with  fore- 
sight and  wisdom,  not  beginning  dangerous  opera- 
tions until  he  has  provided  himself  with  everything 
necessary  for  lessening  the  danger.  He  should  have 
well-shaped  members,  especially  hands  with  long, 
slender  fingers,  mobile  and  not  tremulous,  and  with 
all  his  members  strong  and  healthy  so  that  he  may 
perform  all  the  good  operations  without  disturb- 
ance of  mind.  He  must  be  highly  moral,  should  care 
for  the  poor  for  Grod's  sake,  see  that  he  makes  him- 
self well  paid  by  the  rich,  should  comfort  his  pa- 
tients by  pleasant  discourse,  and  should  always  ac- 
cede to  their  requests  if  these  do  not  interfere  with 
the  cure  of  the  disease.' '  "  It  follows  from  this," 
he  says,  ' '  that  the  perfect  surgeon  is  more  than  the 
perfect  physician,  and  that  while  he  must  know  medi- 
cine he  must  in  addition  know  his  handicraft. ' ' 

Thinking  thus,  it  is  no  wonder  that  he  places  his 
book  under  as  noble  patronage  as  possible.  He  says 
in  the  preface  that  he  "  began  to  write  it  for  the 
honor  and  praise  of  Christ  Jesus,  of  the  Virgin  Mary, 
of  the  Saints  and  Martyrs,  Cosmas  and  Damian,  and 
of  King  Philip  of  France  as  well  as  his  four  chil- 
dren, and  on  the  proposal  and  request  of  Master 
William  of  Briscia,  distinguished  professor  in  the 
science  of  medicine  and  formerly  physician  to  Pope 
Boniface  IV  and  Benedict  and  Clement,  the  present 
Pope."  His  first  book  on  anatomy  he  proposed  to 
found  on  that  of  Avicenna  and  ' '  on  his  personal  ex- 


GBEAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    269 

perience  as  lie  has  seen  it."  The  second  tractate  on 
the  treatments  of  wounds,  contusions,  and  ulcers 
was  founded  on  the  second  book  of  Theodoric  i '  with 
whatever  by  recent  study  has  been  newly  acquired 
and  brought  to  light  through  the  experience  of  mod- 
ern physicians."  He  then  confesses  his  obligations 
to  his  great  master,  John  Pitard,  and  adds  that  all 
the  experience  that  he  has  gained  while  operating, 
studying,  and  lecturing  for  many  years  on  surgery 
will  be  made  use  of  in  order  to  enhance  the  value 
of  the  work.  He  hopes,  however,  to  accomplish  all 
this  "  briefly,  quietly,  and  above  all,  charitably." 
There  are  many  things  in  the  preface  that  show  us 
the  reason  for  Mondeville's  popularity,  for  they  ex- 
hibit him  as  very  sympathetically  human  in  his  in- 
terests. 

While  Mondeville  is  devoted  to  the  principle  that 
authority  is  of  great  value,  he  said  that  there  was 
nothing  perfect  in  things  human,  and  successive  gen- 
erations of  younger  men  often  made  important  addi- 
tions to  what  their  ancestors  had  left  them.  While 
his  work  is  largely  a  compilation,  nearly  everywhere 
it  shows  signs  of  the  modification  of  his  predecessors' 
opinions  by  the  results  of  his  own  experience.  His 
method  of  writing  is,  as  Pagel  declares, i '  always  in- 
teresting, lively,  and  often  full  of  meat. ' '  He  had  a 
teacher 's  instinct,  for  in  several  of  the  earlier  manu- 
scripts his  special  teaching  is  put  in  larger  letters 
in  order  to  attract  students '  attention.  .  .  He  seems 
to  have  introduced  or  re-introduced  into  practice  the 
idea  of  the  use  of  a  large  magnet  in  order  to  extract 
portions  of  iron  from  the  tissues.  He  made  several 
modifications  in  needles  and  thread  holders  and  in- 


270  OLD-TIME  MAKERS  OF  MEDICINE 

vented  a  kind  of  small  derrick  for  the  extraction  of 
arrows  with  barbs.  Besides,  lie  suggested  the  sur- 
rounding of  the  barbs  of  the  arrows  with  tubes,  to 
facilitate  extraction.  In  his  treatment  of  wounds, 
Pagel  considers  that  as  a  writer  and  teacher  he  is 
far  ahead  of  his  predecessors  and  even  of  those  who 
came  after  him  in  immediately  subsequent  genera- 
tions. One  of  his  great  merits  undoubtedly  is  that 
Guy  de  Chauliac,  the  father  of  modern  surgery,  in 
his  text-book  turned  to  him  with  a  confidence  that 
proclaims  his  admiration  and  how  much  he  felt  that 
he  had  gained  from  him. 

One  of  the  most  interesting  features  of  Monde- 
ville's  work  is  his  insistence  on  the  influence  of  the 
mind  on  the  body  and  the  importance  of  using  this 
influence  to  the  best  advantage.  It  is  especially  im- 
portant in  Mondeville's  opinion  to  keep  a  surgical 
patient  from  being  moody.  ' '  Let  the  surgeon, ' '  says 
he,  ' '  take  care  to  regulate  the  whole  regimen  of  the 
patient's  life  for  joy  and  happiness  by  promising 
that  he  will  soon  be  well,  by  allowing  his  relatives 
and  special  friends  to  cheer  him  and  by  having  some- 
one to  tell  him  jokes,  and  let  him  be  solaced  also  by 
music  on  the  viol  or  psaltery.  The  surgeon  must 
forbid  anger,  hatred,  and  sadness  in  the  patient,  and 
remind  him  that  the  body  grows  fat  from  joy  and 
thin  from  sadness.  He  must  insist  on  the  patient 
obeying  him  faithfully  in  all  things.  He  repeats  with 
approval  the  expression  of  Avicenna  that  "  often  the 
confidence  of  the  patient  in  his  physician  does  more 
for  the  cure  of  his  disease  than  the  physician  with 
all  his  remedies.' '  Obstinate  and  conceited  patients 
prone  to  object  to  nearly  everything  that  the  sur- 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    271 

geon  wants  to  do,  and  who  often  seem  to  think  that 
they  surpass  Galen  and  Hippocrates  in  science  and 
wisdom,  are  likely  to  delay  their  cure  very  much,  and 
they  represent  the  cases  with  which  the  surgeon  has 
much  difficulty. 

Mondeville  thought  that  nursing  was  extremely 
important  and  that  without  it  surgery  often  failed 
of  its  purpose.  He  says,  i '  For  if  the  assistants  are 
not  solicitous  and  faithful,  and  obedient  to  the  sur- 
geons in  each  and  every  thing  which  may  make  for 
the  cure  of  the  disease,  they  put  obstacles  and  diffi- 
culties in  the  way  of  the  surgeon.' '  It  is  especially 
important  that  the  patient's  nutrition  should  be 
cared  for  and  that  the  bandages  should  be  managed 
exactly  as  the  surgeon  directs.  He  has  no  use  for 
garrulous,  talkative  nurses,  and  does  not  hesitate  to 
say  that  sometimes  near  relatives  are  particularly 
likely  to  disturb  patients.  "  Especially  are  they  prone 
to  let  drop  some  hint  of  bad  news  which  the  surgeon 
may  have  revealed  to  them  in  secret,  or  even  the 
reports  that  they  may  hear  from  others,  friends  or 
enemies,  and  this  provokes  the  patient  to  anger  or 
anxiety  and  is  likely  to  give  him  fever.  If  the  as- 
sistants quarrel  among  themselves,  or  are  heard  mur- 
muring, or  if  they  draw  long  faces,  all  of  these 
things  will  disturb  the  patients  and  produce  worry 
and  anxiety  or  fear.  The  surgeon  therefore  must  be 
careful  in  the  selection  of  his  nurses,  for  some  of 
them  obey  very  well  while  he  is  present,  but  do  as 
they  like  and  often  just  exactly  the  opposite  of  what 
he  has  directed  when  he  is  away. ' ' 

We  do  not  know  enough  of  the  details  of  Monde- 
ville's  life  to  be  sure  whether  he  was  married  or  not. 


272  OLD-TIME  MAKERS  OF  MEDICINE 

It  is  probable  that  he  was  not,  for  all  of  these  sur- 
geons of  the  thirteenth  century  before  Mondeville 's 
time,  Theodoric,  William  of  Salicet,  Lanfranc,  and 
Guy  de  Chauliac,  after  him  belonged  to  the  clerical 
order;  Theodoric  was  a  bishop;  the  others,  how- 
ever, seem  only  to  have  been  in  minor  orders.  It 
is  therefore  from  the  standpoint  of  a  man  who  views 
married  life  from  without  that  Mondeville  makes  his 
remarks  as  to  the  difficulty  often  encountered  when 
wives  nurse  their  husbands.  He  says  that  the  sur- 
geon has  difficulty  oftener  when  husbands  or  wives 
care  for  their  spouses  than  at  other  times.  This  is 
much  more  likely  to  take  place  when  the  wives  are 
caring  for  the  husbands.  "  In  our  days,"  he  says, 
"  in  this  Gallican  part  of  the  world,  wives  rule  their 
husbands,  and  the  men  for  the  most  part  permit 
themselves  to  be  ruled.  Whatever  a  surgeon  may 
order  for  the  cure  of  a  husband  then  will  often  seem 
to  the  wives  to  be  a  waste  of  good  material,  though 
the  men  seem  to  be  quite  willing  to  get  anything  that 
may  be  ordered  for  the  cure  of  their  wives.  The 
whole  cause  of  this  seems  to  be  that  every  woman 
seems  to  think  that  her  husband  is  not  as  good  as 
those  of  other  women  whom  she  sees  around  her." 
It  would  be  interesting  to  know  how  Mondeville  was 
brought  to  a  conclusion  so  different  from  modern 
experience  in  the  matter. 

For  those  who  are  particularly  interested  in  med- 
ical history  one  of  the  sections  of  Henry's  book  has 
a  special  appeal,  because  he  gives  in  it  a  sketch  of 
the  history  of  surgery.  We  are  little  likely  to  think, 
as  a  rule,  that  at  this  time,  full  two  centuries  before 
the  close  of  the  Middle  Ages,  men  were  interested 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    273 

enough  in  the  doings  of  those  who  had  gone  before 
them  to  try  to  trace  the  history  of  the  development  of 
their  specialty.  It  is  characteristic  of  the  way  that 
the  scholarly  Mondeville  views  his  own  life  work 
that  he  should  have  wanted  to  know  something  about 
his  predecessors  and  teach  others  with  regard  to 
them.  He  begins  with  Galen,  and  as  Galen  divides 
the  famous  physicians  of  the  world  into  three  sects, 
the  Methodists,  the  Empirics,  and  the  Eationalists, 
so  Mondeville  divides  modern  surgery  into  three 
sects:  first,  that  of  the  Salernitans,  with  Roger, 
Roland,  and  the  Four  Masters ;  second,  that  of  Wil- 
liam of  Salicet  and  Lanfranc;  and  third,  that  of 
Hugo  de  Lucca  and  his  brother  Theodoric  and  their 
modern  disciples.  He  states  briefly  the  characteris- 
tics of  these  three  sects.  The  first  limited  patients' 
diet,  used  no  stimulants,  dilated  all  wounds,  and  got 
union  only  after  pus  formation.  The  second  allowed 
a  liberal  diet  to  weak  patients,  though  not  to  the 
strong,  but  generally  interfered  with  wounds  too 
much.  The  third  believed  in  a  liberal  diet,  never  di- 
lated wounds,  never  inserted  tents,  and  its  members 
were  extremely  careful  not  to  complicate  wounds  of 
the  head  by  unwise  interference.  His  critical  dis- 
cussion of  the  three  schools  is  extremely  interesting. 
Another  phase  of  Mondeville 's  work  that  is  sym- 
pathetic to  the  moderns  is  his  discussion  of  the  ir- 
regular practice  of  medicine  and  surgery  as  it  existed 
in  his  time.  Most  of  our  modern  medicine  and  sur- 
gery was  anticipated  in  the  olden  time;  but  it  may 
be  said  that  all  of  the  modes  of  the  quack  are  as  old 
as  humanity.  Galen's  description  of  the  travelling 
charlatan  who  settled  down  in  his  front  yard,  not 


274  OLD-TIME  MAKERS  OF  MEDICINE 

knowing  that  it  belonged  to  a  physician,  shows  this 
very  well.  There  were  evidently  as  many  of  them 
and  as  many  different  kinds  in  Mondeville's  time  as 
in  our  own.  In  discussing  the  opposition  that  had 
arisen  between  physicians  and  surgeons  in  his  time 
and  their  failure  to  realize  that  they  were  both  mem- 
bers of  a  great  profession,  he  enumerates  the  many 
different  kinds  of  opponents  that  the  medical  profes- 
sion had.  There  were  "  barbers,  soothsayers,  loan 
agents,  falsifiers,  alchemists,  meretrices,  midwives, 
old  women,  converted  Jews,  Saracens,  and  indeed 
most  of  those  who,  having  wasted  their  substance 
foolishly,  now  proceed  to  make  physicians  or  sur- 
geons of  themselves  in  order  to  make  their  living 
under  the  cloak  of  healing. ' ' 

What  surprises  Mondeville  however,  as  it  has  al- 
ways surprised  every  physician  who  knows  the  sit- 
uation, is  that  so  many  educated,  or  at  least  sup- 
posedly well-informed  people  of  the  better  classes, 
indeed  even  of  the  so-called  best  classes,  allow  them- 
selves to  be  influenced  by  these  quacks.  And  it  is 
even  more  surprising  to  him  that  so  many  well-to-do, 
intelligent  people  should,  for  no  reason,  though  with- 
out knowledge,  presume  to  give  advice  in  medical 
matters  and  especially  in  even  dangerous  surgical 
diseases,  and  in  such  delicate  affections  as  diseases 
of  the  eyes.  "  It  thus  often  happens  that  diseases 
in  themselves  curable  grow  to  be  simply  incurable  or 
are  made  much  worse  than  they  were  before.' '  He 
says  that  some  of  the  clergymen  of  his  time  seemed 
to  think  that  a  knowledge  of  medicine  is  infused  into 
them  with  the  sacrament  of  Holy  Orders.  He  was 
himself  probably  a  clergyman,  and  I  have  in  the 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    275 

modern  time  more  than  once  known  of  teachers  in 
the  clerical  seminaries  emphasizing  this  same  idea 
for  the  clerical  students.  It  is  very  evident  that  the 
world  has  not  changed  very  much,  and  that  to  know 
any  time  reasonably  well  is  to  find  in  it  comments 
on  the  morning  paper.  We  are  in  the  midst  of  just 
such  a  series  of  interferences  with  medicine  on  the 
part  of  the  clergy  as  this  wise,  common-sense  sur- 
geon of  the  thirteenth  century  deprecated. 

In  every  way  Mondeville  had  the  instincts  of  a 
teacher.  He  took  advantage  of  every  aid.  He  was 
probably  the  first  to  use  illustrations  in  teaching 
anatomy.  Guy  de  Chauliac,  whose  teacher  in  anat- 
omy for  some  time  Mondeville  was,  says  in  the  first 
chapter  of  his  "  Chirurgia  Magna  "  that  pictures 
do  not  suffice  for  the  teaching  of  anatomy  and  that 
actual  dissection  is  necessary.  The  passage  runs 
as  follows :  ' i  In  the  bodies  of  men,  of  apes,  and  of 
pigs,  and  of  many  other  animals,  tissues  should  be 
studied  by  dissections  and  not  by  pictures,  as  did 
Henricus,  who  was  seen  to  demonstrate  anatomy 
with  thirteen  pictures.' ' x  What  Chauliac  blames  is 
the  attempt  to  replace  dissections  by  pictorial  de- 
monstrations. Hyrtl,  however,  suggests  that  this  in- 
vention of  Mondeville 's  was  probably  very  helpful, 
and  was  brought  about  by  the  impossibility  of  pre- 


1  In  the  very  first  book  containing  some  account  of  human  anatomy, 
a  German  volume  by  Conradus  Mengenberger,  called  "  Puch  der  Na- 
tur,"  the  date  of  printing  of  which  is  about  1478, — that  is,  less  than  ten 
years  after  the  printing  of  the  very  first  book,  the  "Bibliapauperum," 
which  appeared  in  1470,— there  are,  according  to  Haller  in  his  "Biblio- 
theca  Anatomica,"  a  series  of  illustrations.  This  is  the  first  illustrated 
medical  work  ever  published. 


276  OLD-TIME  MAKERS  OF  MEDICINE 

serving  bodies  for  long  periods  as  well  as  the  dif- 
ficulty of  obtaining  them. 


YPERMAN" 

One  of  the  maxims  of  the  old  Greek  philosophers 
was  that  good  is  diffusive  of  itself.  As  the  scholas- 
tics put  it,  bonum  est  diffusivum  sui.  This  proved 
to  be  eminently  true  of  the  old  universities  also,  and 
especially  of  their  training  in  medicine  and  in  sur- 
gery. We  have  the  accounts  of  men  from  many  na- 
tions who  went  to  the  universities  and  returned  to 
benefit  their  own  people.  Early  in  the  thirteenth  cen- 
tury Richard  the  Englishman  was  in  Italy,  having 
previously  been  in  Paris  and  probably  atMontpellier. 
Bernard  Gordon,  probably  also  an  Englishman,  was 
one  of  the  great  lights  in  medicine  down  at  Mont- 
pellier,  and  his  book, ' '  Lilium  De  Medicina, ' '  is  well 
known.  Two  distinguished  surgeons  whose  names 
have  come  down  to  us,  having  studied  in  Paris  after 
Lanfranc  had  created  the  tradition  of  great  surgical 
teaching  there,  came  to  their  homes  to  be  centres  of 
beneficent  influence  among  their  people  in  this  mat- 
ter. One  was  Yperman,  of  the  town  of  Ypres  in 
Belgium;  the  other  Ardern  of  England.  Ypermann 
was  sent  by  his  fellow-townsmen  to  Paris  in  order 
to  study  surgery,  because  they  wanted  to  have  a 
good  surgeon  in  their  town  and  Paris  seemed  the 
best  school  at  that  time.  Ypres  was  at  this  period 
one  of  the  greatest  commercial  cities  of  Europe,  and 
probably  had  a  couple  of  hundred  thousand  inhab- 
itants. The  great  hall  of  the  cloth  gild,  which  has 
been  such  an  attraction  for  visitors  ever  since,  was 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    277 

built  shortly  before  the  town  determined  upon  the 
very  sensible  procedure  of  securing  good  surgery 
beyond  all  doubt  by  having  a  townsman  specially 
educated  for  that  purpose. 

Yperman 's  work  was  practically  unknown  to  us 
until  Broeck,  the  Belgian  historian,  discovered  man- 
uscript copies  of  his  book  on  surgery  and  gath- 
ered some  details  of  his  life.  After  his  return  from 
Paris,  Yperman  obtained  great  renown,  which 
maintained  itself  in  the  custom  extant  in  that 
part  of  the  country  even  yet  of  calling  an  expert 
surgeon  an  Yperman.  He  is  the  author  of  two 
works  in  Flemish.  One  of  these  is  a  smaller  com- 
pendium of  internal  medicine,  which  is  very  inter- 
esting, however,  because  it  shows  the  many  subjects 
that  were  occupying  physicians '  minds  at  that  time. 
He  treats  of  dropsy,  rheumatism,  under  which  occur 
the  terms  coryza  and  catarrh  (the  flowing  diseases), 
icterus,  phthisis  (he  calls  the  tuberculosis,  tysiken), 
apoplexy,  epilepsy,  frenzy,  lethargy,  fallen  palate, 
cough,  shortness  of  breath,  lung  abscess,  hemor- 
rhage, blood-spitting,  liver  abscess,  hardening  of  the 
spleen,  affections  of  the  kidney,  bloody  urine,  dia- 
betes, incontinence  of  urine,  dysuria,  strangury, 
gonorrhea,  and  involuntary  seminal  emissions — all 
these  terms  are  quoted  directly  from  PagePs  ac- 
count of  his  work;  the  original  is  not  available  in 
this  country. 

JOHN  AKDEEN 

In  English-speaking  countries  of  course  we  are  in- 
terested in  what  was  done  by  Englishmen  at  this 


278  OLD-TIME  MAKERS  OF  MEDICINE 

time.  Fortunately  we  have  the  record  of  one  great 
English  surgeon  of  the  period  worthy  to  be  placed 
beside  even  the  writers  already  mentioned.  This 
is  John  Ardern,  whose  name  is  probably  a  modifica- 
tion of  the  more  familiar  Arden,  whose  career  well 
deserves  attention.  I  have  given  a  sketch  of  his 
work  in  "  The  Popes  and  Science.' ' x  He  was  edu- 
cated at  Montpellier,  and  practised  surgery  for  a 
time  in  France.  About  the  middle  of  the  century  how- 
ever, according  to  Pagel,  he  went  back  to  his  native 
land  and  settled  for  some  twenty  years  at  Newark, 
in  Nottinghamshire,  and  then  for  nearly  thirty  years 
longer,  until  about  the  end  of  the  century,  was  in 
London.  He  is  the  chief  representative  of  English 
surgery  during  the  Middle  Ages.  His  "  Practica," 
as  yet  unprinted,  contains,  according  to  Pagel,  a 
short  sketch  of  internal  medicine,  but  is  mainly  de- 
voted to  surgery.  Contrary  to  the  usual  impression 
with  regard  to  works  in  medicine  and  surgery  at 
this  time,  the  book  abounds  in  references  to  case  his- 
tories which  Ardern  had  gathered,  partly  from  his 
own  and  partly  from  others'  experience.  The  thera- 
peutic measures  that  he  suggests  are  usually  very 
simple,  in  the  majority  of  cases  quite  rational, 
though,  of  course,  there  are  many  superstitions 
among  them;  but  Ardern  always  furnished  a  num- 
ber of  suggestions  from  which  to  choose.  He  must 
have  been  an  expert  operator,  and  had  excellent  suc- 
cess in  the  treatment  of  diseases  of  the  rectum.  He 
seems  to  have  been  the  first  operator  who  made 
careful  statistics  of  his  cases,  and  was  quite  as  proud 

1Fordham  University  Press,  New  York,  1908. 


GREAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    279 

as  any  modern  surgeon  of  the  large  numbers  that 
he  had  operated  on,  which  he  gives  very  exactly. 
He  was  the  inventor  of  a  new  clyster  apparatus. 

Fortunately  we  possess  here  in  America,  in  the 
Surgeon  General's  Library  at  Washington,  a  very 
interesting  manuscript  containing  Ardern's  surgical 
writings,  though  it  has  not  yet  been  published.  Even 
a  little  study  of  this  and  of  the  notes  on  it  prepared 
by  an  English  bibliophile  before  its  purchase  by  the 
Surgeon  General 's  Library,  serves  to  show  how  val- 
uable the  work  is  in  the  history  of  surgery.  There 
are  illustrations  scarcely  less  interesting  than  the 
text.  Some  of  these  illustrations  were  inserted  by 
the  original  writer  or  copyist,  and  some  of  them  later. 
In  general,  however,  they  show  a  rather  high  devel- 
opment of  the  mechanics  of  surgery  at  that  time. 
Some  of  the  pages  have  spaces  for  illustrations  left 
unfilled,  so  that  evidently  the  copyist  did  not  com- 
plete his  work.  The  titles  of  certain  of  the  chapters 
are  interesting,  as  illustrating  the  fact  that  our 
medical  and  surgical  problems  were  stated  clearly 
in  the  olden  time,  and  thinking  physicians,  even  six 
centuries  ago,  met  them  quite  rationally.  There  is, 
for  instance,  a  chapter  headed  "  Against  Colic  and 
the  Iliac  Passion,' '  immediately  followed  by  the  sub- 
heading, "  Method  of  Administering  Clysters." 
The  iliac  passion,  passio  iliaca  of  the  old  Latin,  is 
usually  taken  to  signify  some  obstruction  of  the  in- 
testines causing  severe  pain,  vomiting,  and  eventu- 
ally fecal  vomiting.  A  good  many  different  forms 
of  severe  painful  conditions,  especially  all  those  com- 
plicated by  peritonitis,  were  included  under  the  term, 
and  the  modern  student  of  surgery  is  likely  to  won- 


280  OLD-TIME  MAKEMS  OF  MEDICINE 

der  whether  these  old  observers  had  not  noted  that 
the  right  iliac  region  was  particularly  psone  to  be 
the  source  of  fatal  conditions.  There  is  a  chapter 
entitled  "  Against  Pain  in  the  Loins  and  the  Kid- 
neys/ '  followed  by  the  chapter  subheading, 
' '  Against  Stone  in  the  Kidneys. ' '  There  is  a  chap- 
ter with  the  title,  '  *  Against  Ulceration  of  the  Blad- 
der or  the  Kidneys.' '  Another  one,  with  the  title 
"  Against  Burning  of  the  Urine  and  Excoriation  of 
the  Lower  Part  of  the  Yard. ' '  Gonorrhea  is  frankly 
treated  under  the  name  Shawdepisse,  evidently  an 
English  alliteration  of  the  corresponding  French 
word.  As  to  the  instrumentation  of  such  conditions 
and  for  probing  in  general,  Ardern  suggests  the  use 
of  a  lead  probe,  because  it  may  readily  be  made  to 
bend  any  way  and  not  injure  the  tissues. 

MEDIEVAL   SURGERY 

Even  this  brief  account  of  the  surgeons  who  taught 
and  studied  at  the  medieval  universities  demon- 
strates what  fine  work  they  did.  It  is  surely  not  too 
much  to  say  that  the  chapter  on  university  educa- 
tion mainly  concerned  with  them  is  one  of  the  most 
interesting  in  the  whole  history  of  the  universities. 
Their  story  alone  is  quite  enough  to  refute  most  of 
the  prevalent  impressions  and  patronizing  expres- 
sions with  regard  to  medieval  education.  Their 
careers  serve  to  show  how  interested  were  the  men 
of  many  nations  in  the  development  of  an  extremely 
important  application  of  science  for  the  benefit  of 
sutler ing  humanity.  Their  work  utterly  contradicts 
the  idea  so  frequently  emphasized  that  the  great 


GBEAT  SURGEONS  OF  MEDIEVAL  UNIVERSITIES    281 

students  of  the  Middle  Ages  were  lacking  in  prac- 
ticalness. Besides,  they  make  very  clear  that  we 
have  been  prone  to  judge  the  Middle  Ages  too  much 
from  its  speculative  philosophies.  It  has  been  the 
custom  to  say  that  speculation  ruled  men's  minds 
and  prevented  them  from  making  observations,  de- 
veloping science,  or  applying  scientific  principles. 
There  was  much  speculation  during  the  Middle  Ages, 
but  probably  not  any  more  in  proportion  than  exists 
at  the  present  day.  We  were  either  not  acquainted 
with,  or  failed  to  appreciate  properly,  until  com- 
paratively recent  years,  the  other  side  of  medieval 
accomplishment.  Our  ignorance  led  us  into  misun- 
derstanding of  what  these  generations  really  did.  It 
was  our  own  fault,  because  during  the  Kenaissance 
practically  all  of  these  books  were  edited  and  printed 
under  the  direction  cf  the  great  scholars  of  the  time 
in  fine  editions,  but  during  the  eighteenth  century 
nearly  all  interest  was  lost  in  them,  and  we  are  only 
now  beginning  to  get  back  a  certain  amount  of  the 
precious  knowledge  that  they  had  in  the  Kenaissance 
period  of  this  other  side  of  medieval  life.  We  have 
learned  so  much  about  surgery  because  distinguished 
scholars  devoted  themselves  to  this  phase  of  the  his- 
tory of  science.  Doubtless  there  are  many  other 
phases  of  the  history  of  science  which  suffered  the 
same  fate  of  neglect  and  with  regard  to  which  the 
future  will  bring  us  equally  startling  revelations. 
For  this  reason  this  marvellous  chapter  in  the  his- 
tory of  surgery  is  a  warning  as  well  as  a  startling 
record  of  a  marvellous  epoch  of  human  progress. 


XI 

GUY  DE  CHAULIAC 

One  of  the  most  interesting  characters  in  the  his- 
tory of  medieval  medicine,  and  undoubtedly  the  most 
important  and  significant  of  these  Old-Time  Makers 
of  Medicine,  is  Guy  de  Chauliac.  Most  of  the  false  no- 
tions so  commonly  accepted  with  regard  to  the  Mid- 
dle Ages  at  once  disappear  after  a  careful  study  of 
his  career.  The  idea  of  the  careful  application  of 
scientific  principles  in  a  great  practical  way  is  far 
removed  from  the  ordinary  notion  of  medieval  pro- 
cedure. Some  observations  we  may  concede  that 
they  did  make,  but  we  are  inclined  to  think  that  these 
were  not  regularly  ordered  and  the  lessons  of  them 
not  drawn  so  as  to  make  them  valuable  as  experi- 
ences. Great  art  men  may  have  had,  but  science  and, 
above  all,  applied  science,  is  a  later  development  of 
humanity.  Particularly  is  this  supposed  to  be  true 
with  regard  to  the  science  and  practice  of  surgery, 
which  is  assumed  to  be  of  comparatively  recent 
origin.  Nothing  could  well  be  less  true,  and  if  the 
thoroughly  practical  development  of  surgery  may  be 
taken  as  a  symbol  of  how  capable  men  were  of  apply- 
ing science  and  scientific  principles,  then  it  is  com- 
paratively easy  to  show  that  the  men  of  the  later 
Middle  Ages  were  occupied  very  much  as  have  been 
our  recent  generations  with  science  and  its  practical 
applications. 

282 


GUT  DE  CHAULIAC  283 

The  immediate  evidence  of  the  value  of  old-time 
surgery  is  to  be  found  in  the  fact  that  Guy  de 
Chauliac,  who  is  commonly  spoken  of  in  the  history 
of  medicine  as  the  Father  of  Modern  Surgery,  lived 
his  seventy-odd  years  of  life  during  the  fourteenth 
century  and  accomplished  the  best  of  his  work, 
therefore,  some  five  centuries  before  surgery  in  our 
modern  sense  of  the  term  is  supposed  to  have  de- 
veloped. A  glance  at  his  career,  however,  will  show 
how  old  are  most  of  the  important  developments 
of  surgery,  as  also  in  what  a  thoroughly  scientific 
temper  of  mind  this  subject  was  approached  more 
than  a  century  before  the  close  of  the  Middle  Ages. 
The  life  of  this  French  surgeon,  indeed,  who  was  a 
cleric  and  occupied  the  position  of  chamberlain  and 
physician-in-ordinary  to  three  of  the  Avignon  Popes, 
is  not  only  a  contradiction  of  many  of  the  tradi- 
tions as  to  the  backwardness  of  our  medieval  for- 
bears in  medicine,  that  are  readily  accepted  by  many 
presumably  educated  people,  but  it  is  the  best  pos- 
sible antidote  for  that  insistent  misunderstanding  of 
the  Middle  Ages  which  attributes  profound  igno- 
rance of  science,  almost  complete  failure  of  observa- 
tion, and  an  absolute  lack  of  initiative  in  applica- 
tions of  science  to  the  men  of  those  times. 

Guy  de  Chauliac 's  life  is  modern  in  nearly  every 
phase.  He  was  educated  in  a  little  town  of  the 
south  of  France,  made  his  medical  studies  at  Mont- 
pellier,  and  then  went  on  a  journey  of  hundreds  of 
miles  into  Italy,  in  order  to  make  his  post-graduate 
studies.  Italy  occupied  the  place  in  science  at  that 
time  that  Germany  has  taken  during  the  nineteenth 
century.    A  young  man  who  wanted  to  get  into  touch 


284  OLD-TIME  MAKERS  OF  MEDICINE 

with  the  great  masters  in  medicine  naturally  went 
down  into  the  Peninsula.  Traditions  as  to  the  atti- 
tude of  the  Church  to  science  notwithstanding,  Italy 
where  education  was  more  completely  under  the 
influence  of  the  Popes  and  ecclesiastics  than  in  any 
other  country  in  Europe,  continued  to  be  the  home 
of  post-graduate  work  in  science  for  the  next  four 
centuries.  Almost  needless  to  say,  the  journey  to 
Italy  was  more  difficult  of  accomplishment  and  in- 
volved more  expense  and  time  than  would  even  the 
voyage  from  America  to  Europe  in  our  time.  Chau- 
liac  realized,  however,  that  both  time  and  expense 
would  be  well  rewarded,  and  his  ardor  for  the  round- 
ing out  of  his  education  was  amply  recompensed 
by  the  event.  Nor  have  we  any  reason  for  thinking 
that  what  he  did  was  very  rare,  much  less  unique, 
in  his  time.  Many  a  student  from  France,  Germany, 
and  England  made  the  long  journey  to  Italy  for 
post-graduate  opportunities  during  the  later  Middle 
Ages. 

Even  this  post-graduate  experience  in  Italy  did 
not  satisfy  Chauliac,  however,  for,  after  having 
studied  several  years  with  the  most  distinguished 
Italian  teachers  of  anatomy  and  surgery,  he  spent 
some  time  in  Paris,  apparently  so  as  to  be  sure  that 
he  would  be  acquainted  with  the  best  that  was  being 
done  in  his  specialty  in  every  part  of  the  world.  He 
then  settled  down  to  his  own  life  work,  carrying  his 
Italian  and  French  masters'  teachings  well  beyond 
the  point  where  he  received  them,  and  after  years 
of  personal  experience  he  gathered  together  his 
masters'  ideas,  tested  by  his  own  observations,  into 
his  "  Chirurgia  Magna,"  a  great  text-book  of  sur- 


GUY  BE  CHAULIAC  285 

gery  which  sums  up  the  whole  subject  succinctly, 
yet  completely,  for  succeeding  generations.  When 
we  talk  about  what  he  accomplished  for  surgery,  we 
are  not  dependent  on  traditions  nor  vague  informa- 
tion gleaned  from  contemporaries  and  successors, 
who  might  perhaps  have  been  so  much  impressed 
by  his  personality  as  to  be  made  over-enthusiastic 
in  their  critical  judgment  of  him.  We  know  the  man 
in  his  surgical  works,  and  they  have  continued  to  be 
classics  in  surgery  ever  since.  It  is  an  honorable 
distinction  for  the  medicine  of  the  later  fourteenth, 
the  fifteenth,  and  sixteenth  centuries  that  Guy  de 
Chauliac 's  book  was  the  most  read  volume  of  the 
time  in  medicine.  Evidently  the  career  of  such  a 
man  is  of  import,  not  alone  to  physicians,  but  to  all 
who  are  interested  in  the  history  of  education. 

Chauliac  derives  his  name  from  the  little  town 
of  Chauliac  in  the  diocese  of  Mende,  almost  in  the 
centre  of  what  is  now  the  department  of  Lozere. 
The  records  of  births  and  deaths  were  not  consid- 
ered so  important  in  the  fourteenth  century  as  they 
are  now,  and  so  we  are  not  sure  of  either  in  the  case 
of  Chauliac.  It  is  usually  considered  that  he  was 
born  some  time  during  the  last  decade  of  the  thir- 
teenth century,  probably  toward  the  end  of  it,  and 
that  he  died  about  1370.  Of  his  early  education  we 
know  nothing,  but  it  must  have  been  reasonably 
efficient,  since  it  gave  him  a  good  working  knowledge 
of  Latin,  which  was  the  universal  language  of  science 
and  especially  of  medicine  at  that  time ;  and  though 
his  own  style,  as  must  be  expected,  is  no  better  than 
that  of  his  contemporaries,  he  knew  how  to  express 
his  thoughts  clearly  in  straightforward  Latin,  with 


286  OLD-TIME  MAKERS  OF  MEDICINE 

only  such  a  mixture  of  foreign  terms  as  his  studies 
suggested  and  the  exigencies  of  a  new  development 
of  science  almost  required.  Later  in  life  he  seems 
to  have  known  Arabic  very  well,  for  he  is  evidently 
familiar  with  Arabian  books  and  does  not  depend 
merely  on  translations  of  them. 

Pagel,  in  the  first  volume  of  Puschmann's  "  Hand- 
book of  the  History  of  Medicine,' '  says,  on  the 
authority  of  Nicaise  and  others,  that  Chauliac  re- 
ceived his  early  education  from  the  village  clergy- 
man. His  parents  were  poor,  and  but  for  ecclesi- 
astical interest  in  him  it  would  have  been  difficult 
for  him  to  obtain  his  education.  The  Church  sup- 
plied at  that  time  to  a  great  extent  for  the  founda- 
tions and  scholarships,  home  and  travelling,  of  our 
day,  and  Chauliac  was  amongst  the  favored  ones. 
How  well  he  deserved  the  favor  his  subsequent 
career  shows,  as  it  completely  justifies  the  judg- 
ment of  his  patrons.  He  went  first  to  Toulouse,  as 
we  know  from  his  affectionate  mention  of  one  of  his 
teachers  there.  Toulouse  was  more  famous  for  law, 
however,  than  for  medicine,  and  after  a  time  Chau- 
liac sought  Montpellier  to  complete  his  medical 
studies. 

For  English-speaking  people  an  added  interest  in 
Guy  de  Chauliac  will  be  the  fact  that  one  of  his 
teachers  at  Montpellier  was  Bernard  Gordon,  very 
probably  a  Scotchman,  who  taught  for  some  thirty- 
five  years  at  this  famous  university  in  the  south  of 
France,  and  died  near  the  end  of  the  first  quarter 
of  the  fourteenth  century.  One  of  Chauliac 's  fellow- 
students  at  Montpellier  was  John  of  Gaddesden,  the 
first  English  Eoyal  Physician  by  official  appoint- 


GUT  BE  CHAULIAC  287 

ment  of  whom  we  have  any  account.  John  is  men- 
tioned by  Chaucer  in  his  "  Doctor  of  Physic,''  and 
is  usually  looked  upon  as  one  of  the  fathers  of  Eng- 
lish medicine.  Chauliac  did  not  think  much  of  him, 
though  his  reason  for  his  dislike  of  him  will  prob- 
ably be  somewhat  startling  to  those  who  assumejthat 
the  men  of  the  Middle  Ages  always  clung  servilely 
to  authority.  Chauliac 's  objection  to  Gaddesden's 
book  is  that  he  merely  repeats  his  masters  and  does 
not  dare  to  think  for  himself.  It  is  not  hard  to 
understand  that  such  an  independent  thinker  as 
Chauliac  should  have  been  utterly  dissatisfied  with 
a  book  that  did  not  go  beyond  the  forefathers  in 
medicine  that  the  author  quotes.  This  is  the  ex- 
planation of  his  well-known  expression,  "  Last  of  all 
arose  the  scentless  rose  of  England  ['  Eosa  An- 
giise  '  was  the  name  of  John  of  Gaddesden's  book], 
in  which,  on  its  being  sent  to  me,  I  hoped  to  find  the 
odor  of  sweet  originality,  but  instead  of  that  I  en- 
countered only  the  fictions  of  Hispanus,  of  Gilbert, 
and  of  Theodoric." 

The  presence  of  a  Scotch  professor  and  an  Eng- 
lish fellow-student,  afterwards  a  royal  physician,  at 
Montpellier,  at  the  beginning  of  the  fourteenth  cen- 
tury, shows  how  much  more  cosmopolitan  was  uni- 
versity life  in  those  times  than  we  are  prone  to 
think,  and  what  attraction  a  great  university  medical 
school  possessed  even  for  men  from  long  distances. 

After  receiving  his  degree  of  Doctor  of  Medicine 
at  Montpellier  Chauliac  went,  as  we  have  said,  to 
Bologna.  Here  he  attracted  the  attention  and  re- 
ceived the  special  instruction  of  Bertruccio,  who 
was  attracting  students  from  all  over  Europe  at 


288  OLD-TIME  MAKERS  OF  MEDICINE 

this  time  and  was  making  some  excellent  demonstra- 
tions in  anatomy,  employing  human  dissections  very 
freely.  Chauliac  tells  of  the  methods  that  Bertruc- 
cio  used  in  order  that  bodies  might  be  in  as  good 
condition  as  possible  for  demonstration  purposes, 
and  mentions  the  fact  that  he  saw  him  do  many  dis- 
sections in  different  ways. 

In  Both's  life  of  Vesalius,  which  is  usually  con- 
sidered one  of  our  most  authoritative  medical  his- 
torical works  not  only  with  regard  to  the  details  of 
Vesalius'  life,  but  also  in  all  that  concerns  anatomy 
about  that  time  and  for  some  centuries  before,  there 
is  a  passage  quoted  from  Chauliac  himself  which 
shows  how  freely  dissection  was  practised  at  the 
Italian  universities  in  the  fourteenth  century.  This 
passage  deserves  to  be  quoted  at  some  length  be- 
cause there  are  even  serious  historians  who  still 
cite  a  Bull  of  Pope  Boniface  VIII,  issued  in  1300, 
forbidding  the  boiling  and  dismembering  of  bodies 
in  order  to  transport  them  to  long  distances  for 
burial  in  their  own  country,  as  being,  either  rightly 
or  wrongly,  interpreted  as  a  prohibition  of  dissec- 
tion and,  therefore,  preventing  the  development  of 
anatomy.  In  the  notes  to  his  history  of  dissection 
during  this  period  in  Bologna  Koth  says :  ' '  Without 
doubt  the  passage  in  Guy  de  Chauliac  which  tells 
of  having  frequently  seen  dissections,  must  be  con- 
sidered as  referring  to  Bologna.  This  passage  runs 
as  follows :  '  My  master  Bertruccius  conducted  the 
dissection  very  often  after  the  following  manner: 
the  dead  body  having  been  placed  upon  a  bench,  he 
used  to  make  four  lessons  on  it.  In  the  first  the 
nutritional  portions  were  treated,  because  they  are 


GUY  DE  CHAULIAC  289 

so  likely  to  become  putrefied.  In  the  second,  he 
demonstrated  the  spiritual  members;  in  the  third, 
the  animate  members;  in  the  fourth,  the  extrem- 
ities. '  "  (Both,  "  Andreas  Vesalius."  Basel,  1896.) 
Bertruccio  's  master,  Mondino,  is  hailed  in  the  his- 
tory of  medicine  as  the  father  of  dissection.  His 
book  on  dissection  was  for  the  next  three  centuries 
in  the  hands  of  nearly  every  medical  scholar  in 
Europe  who  was  trying  to  do  good  work  in  anatomy. 
It  was  not  displaced  until  Vesalius  came,  the  father 
of  modern  anatomy,  who  revolutionized  the  science 
in  the  Eenaissance  time.  Mondino  had  devoted  him- 
self to  the  subject  with  unfailing  ardor  and  enthusi- 
asm, and  from  everywhere  in  Europe  the  students 
came  to  receive  inspiration  in  his  dissecting-room. 
Within  a  few  years  such  was  the  enthusiasm  for  dis- 
section aroused  by  him  in  Bologna  that  there  were 
many  legal  prosecutions  for  body-snatching,  the  con- 
sequence doubtless  of  a  regulation  of  the  Medical 
Department  of  the  University  of  Bologna,  that  if 
the  students  brought  a  body  to  any  of  their  teachers 
he  was  bound  to  dissect  it  for  them.  Bertruccio, 
Mondino's  disciple  and  successor,  continued  this 
great  work,  and  now  Chauliac,  the  third  in  the  tradi- 
tion, was  to  carry  the  Bolognese  methods  back  to 
France,  and  his  position  as  chamberlain  to  the  Pope 
was  to  give  them  a  wide  vogue  throughout  the  world. 
The  great  French  surgeon's  attitude  toward  anat- 
omy and  dissection  can  be  judged  from  his  famous 
expression  that  "  the  surgeon  ignorant  of  anatomy 
carves  the  human  body  as  a  blind  man  carves 
wood."  The  whole  subject  of  dissection  at  this  time 
has  been  fully  discussed  in  the  first  three  chapters 


290  OLD-TIME  MAKERS  OF  MEDICINE 

of  my  "  Popes  and  Science,"  where  those  who  are 
interested  in  the  matter  may  follow  it  to  their  satis- 
faction.1 

After  his  Bologna  experience  Chauliac  went  to 
Paris.  Evidently  his  indefatigable  desire  to  know 
all  that  there  was  to  be  known  would  not  be  satisfied 
until  he  had  spent  some  time  at  the  great  French 
university  where  Lanfranc,  after  having  studied 
under  William  of  Salicet  in  Italy,  had  gone  to  estab- 
lish that  tradition  of  French  surgery  which,  carried 
on  so  well  by  Mondeville  his  great  successor,  was 
to  maintain  Frenchmen  as  the  leading  surgeons  of 
the  world  until  the  nineteenth  century  (Pagel). 
Lanfranc,  himself  an  Italian,  had  been  exiled  from 
his  native  country,  apparently  because  of  political 
troubles,  but  was  welcomed  at  Paris  because  the 
faculty  realized  that  they  needed  the  inspiration  of 
the  Italian  medical  movement  in  surgery  for  the  es- 
tablishment of  a  good  school  of  surgery  in  connec- 
tion with  the  university.  The  teaching  so  well  begun 
by  Lanfranc  was  magnificently  continued  by  Monde- 
ville and  Arnold  of  Villanova  and  their  disciples. 
Chauliac  was  fortunate  enough  to  come  under  the 
influence  of  Petrus  de  Argentaria,  who  was  worthily 
maintaining  the  tradition  of  practical  teaching  in 
anatomy  and  surgery  so  well  founded  by  his  great 
predecessors  of  the  thirteenth  century.  After  this 
grand  tour  Chauliac  was  himself  prepared  to  do 
work  of  the  highest  order,  for  he  had  been  in  touch 
with  all  that  was  best  in  the  medicine  and  surgery 
of  his  time. 

1Fordham  University  Press,  New  York,  1908. 


GUT  BE  CHAULIAC  291 

Like  many  another  distinguished  member  of  his 
profession,  Chauliac  did  not  settle  down  in  the  scene 
of  his  ultimate  labors  at  once,  but  was  something  of 
a  wanderer.  His  own  words  are,  "  Et  per  multa 
tempora  operatus  fui  in  multis  partibus."  Perhaps 
out  of  gratitude  to  the  clerical  patrons  of  his  native 
town  to  whom  he  owed  so  much,  or  because  of  the 
obligations  he  considered  that  he  owed  them  for  his 
education,  he  practised  first  in  his  native  diocese  of 
Mende ;  thence  he  removed  to  Lyons,  where  we  know 
that  he  lived  for  several  years,  for  in  1344  he  took 
part  as  a  canon  in  a  chapter  that  met  in  the  Church 
of  St.  Just  in  that  city.  Just  when  he  was  called 
to  Avignon  we  do  not  know,  though  when  the  black 
death  ravaged  that  city  in  1348  he  was  the  body- 
physician  of  Pope  Clement  VI,  for  he  is  spoken  of 
in  a  Papal  document  as  "  venerabilis  et  circum- 
spectus  vir,  dominus  Guido  de  Cauliaco,  canonicus  et 
propositus  ecclesice  Sancti  Justi  Lugduni,  medi- 
cusque  domini  Nostri  Papce."  All  the  rest  of  his 
life  was  passed  in  the  Papal  capital,  which  Avignon 
was  for  some  seventy  years  of  the  fourteenth  cen- 
tury. He  served  as  chamberlain-physician  to  three 
Popes,  Clement  VI,  Innocent  VI,  and  Urban  V.  We 
do  not  know  the  exact  date  of  his  death,  but  when 
Pope  Urban  V  went  to  Rome  in  1367,  Chauliac  was 
putting  the  finishing  touches  on  his  "  Chirurgia 
Magna,' '  which,  as  he  tells  us,  was  undertaken  as  a 
solatium  senectutis — a  solace  in  old  age.  When 
Urban  returned  to  Avignon  for  a  time  in  1370 
Chauliac  was  dead.  His  life  work  is  summed  up  for 
us  in  this  great  treatise  on  surgery,  full  of  anticipa- 


292  OLD-TIME  MAKERS  OF  MEDICINE 

tions  in  surgical  procedures  that  we  are  prone  to 
think  much  more  modern. 

Nicaise  has  emphasized  the  principles  which 
guided  Guy  de  Chauliac  in  the  choice  and  interpreta- 
tion of  his  authorities  by  a  quotation  from  Guy 
himself,  which  is  so  different  in  its  tone  from  what 
is  usually  supposed  to  have  been  the  attitude  of  mind 
of  the  men  of  science  of  the  time  that  it  would  be 
well  for  all  those  who  want  to  understand  the  Mid- 
dle Ages  better  to  have  it  near  them.  Speaking  of 
the  surgeons  of  his  own  and  immediately  preceding 
generations,  Guy  says:  "  One  thing  particularly  is 
a  source  of  annoyance  to  me  in  what  these  surgeons 
have  written,  and  it  is  that  they  follow  one  another 
like  so  many  cranes.  For  one  always  says  what  the 
other  says.  I  do  not  know  whether  it  is  from  fear 
or  from  love  that  they  do  not  deign  to  listen  except 
to  such  things  as  they  are  accustomed  to  and  as 
have  been  proved  by  authorities.  They  have  to  my 
mind  understood  very  badly  Aristotle's  second  book 
of  metaphysics  where  he  shows  that  these  two 
things,  fear  and  love,  are  the  greatest  obstacles  on 
the  road  to  the  knowledge  of  the  truth.  Let  them 
give  up  such  friendships  and  fears.  '  Because  while 
Socrates  or  Plato  may  be  a  friend,  truth  is  a 
greater  friend.'  Truth  is  a  holy  thing  and  worthy 
to  be  honored  above  everything  else.  Let  them  fol- 
low the  doctrine  of  Galen,  which  is  entirely  made 
up  of  experience  and  reason,  and  in  which  one  in- 
vestigates things  and  despises  words." 

After  all,  this  is  what  great  authorities  in  medi- 
cine have  always  insisted  on.  Once  every  hundred 
years  or  so  one  finds  a  really  great  observer  who 


GUY  DE  CHAULIAC  293 

makes  new  observations  and  wakes  the  world  up. 
He  is  surprised  that  men  should  not  have  used  their 
powers  of  observation  for  themselves,  but  should 
have  been  following  old-time  masters.  His  corn- 
temporaries  often  refuse  to  listen  to  him  at  first. 
His  observations,  however,  eventually  make  their 
way.  We  blame  the  Middle  Ages  for  following  au- 
thority, but  what  have  we  been  always  doing  but 
following  authority,  except  for  the  geniuses  who 
come  and  lift  us  out  of  the  rut  and  illuminate  a  new 
portion  of  the  realm  of  medicine.  After  they  have 
come,  however,  and  done  their  work,  their  disciples 
proceed  to  see  with  their  eyes  and  to  think  that  they 
are  making  observations  for  themselves  when  they 
are  merely  following  authority.  When  the  next  mas- 
ter in  medicine  comes  along  his  discovery  is  neg- 
lected because  men  have  not  found  it  in  the  old 
books,  and  usually  he  has  to  suffer  for  daring  to 
have  opinions  of  his  own.  The  fact  of  the  matter 
is  that  at  any  time  there  is  only  a  very  limited  num- 
ber of  men  who  think  for  themselves.  The  rest  think 
other  people's  thoughts  and  think  they  are  thinking 
and  doing  things.  As  for  observation,  John  Buskin 
once  said, i  l  Nothing  is  harder  than  to  see  something 
and  tell  it  simply  as  you  saw  it. ' '  This  is  as  true  in 
science  as  in  art,  and  only  genius  succeeds  in  doing 
it  well. 

Chauliac's  book  is  confessedly  a  compilation.  He 
has  taken  the  good  wherever  he  found  it,  though  he 
adds,  modestly  enough,  that ' '  his  work  also  contains 
whatever  his  own  measure  of  intelligence  enabled 
him  to  find  useful  (quce  juxta  modicitatem  mei  in- 
genii  utilia  reputavi).    Indeed  it  is  the  critical  judg- 


294  OLD-TIME  MAKERS  OF  MEDICINE 

inent  displayed  by  Chauliac  in  selecting  from  his 
predecessors  that  best  illustrates  at  once  the  prac- 
tical character  of  his  intellect  and  his  discerning 
spirit.  What  the  men  of  his  time  are  said  to  have 
lacked  is  the  critical  faculty.  They  were  encyclo- 
pedic in  intellect  and  gathered  all  kinds  of  informa- 
tion without  discrimination,  is  a  very  common  criti- 
cism of  medieval  writers.  No  one  can  say  this  of 
Chauliac,  however,  and,  above  all,  he  was  no  re- 
specter of  authority,  merely  for  the  sake  of  author- 
ity. His  criticism  of  John  of  Gaddesden's  book 
shows  that  the  blind  following  of  those  who  had 
gone  before  was  his  special  bete  noir.  His  bitterest 
reproach  for  many  of  his  predecessors  was  that 
"  they  follow  one  another  like  cranes,  whether  for 
love  or  fear,  I  cannot  say." 

Chauliac 's  right  to  the  title  of  father  of  surgery 
will  perhaps  be  best  appreciated  from  the  brief  ac- 
count of  his  recommendations  as  to  the  value  of  sur- 
gical intervention  for  conditions  in  the  three  most 
important  cavities  of  the  body,  the  skull,  the  thorax, 
and  the  abdomen.  These  cavities  have  usually  been 
the  dread  of  surgeons.  Chauliac  not  only  used  the 
trephine,  but  laid  down  very  exact  indications  for  its 
application.  Expectant  treatment  was  to  be  the 
rule  in  wounds  of  the  head,  yet  when  necessary,  in- 
terference was  counselled  as  of  great  value.  His 
prognosis  of  brain  injuries  was  much  better  than 
that  of  his  predecessors.  He  says  that  he  had  seen 
injuries  of  the  brain  followed  by  some  loss  of  brain 
substance,  yet  with  complete  recovery  of  the  patient. 
In  one  case  that  he  notes  a  considerable  amount 
of  brain  substance  was  lost,  yet  the  patient  recovered 


GUY  BE  CHAULIAC  295 

with  only  a  slight  defect  of  memory,  and  even  this 
disappeared  after  a  time.  He  lays  down  exact  indi- 
cations for  the  opening  of  the  thorax,  that  noli  me 
tang  ere  of  surgeons  at  all  times,  even  our  own,  and 
points  out  the  relations  of  the  rihs  and  the  dia- 
phragm, so  as  to  show  just  where  the  opening  should 
be  made  in  order  to  remove  fluid  of  any  kind. 

In  abdominal  conditions,  however,  Chauliac's  an- 
ticipation of  modern  views  is  most  surprising.  He 
recognized  that  wounds  of  the  intestines  were  surely 
fatal  unless  leakage  could  be  prevented.  Accord- 
ingly he  suggested  the  opening  of  the  abdomen  and 
the  sewing  up  of  such  intestinal  wounds  as  could  be 
located.  He  describes  a  method  of  suture  for  these 
cases  and  seems,  like  many  another  abdominal  sur- 
geon, even  to  have  invented  a  special  needleholder. 

To  most  people  it  would  seem  absolutely  out  of  the 
question  that  such  surgical  procedures  could  be  prac- 
tised in  the  fourteenth  century.  We  have  the  definite 
record  of  them,  however,  in  a  text-book  that  was  the 
most  read  volume  on  the  subject  for  several  cen- 
turies. Most  of  the  surprise  with  regard  to  these 
operations  will  vanish  when  it  is  recalled  that  in 
Italy  during  the  thirteenth  century,  as  we  have  al- 
ready seen,  methods  of  anaesthesia  by  means  of 
opium  and  mandragora  were  in  common  use,  having 
been  invented  in  the  twelfth  century  and  perfected 
by  Ugo  da  Lucca,  and  Chauliac  must  not  only  have 
known  but  must  have  frequently  employed  various 
methods  of  anaesthesia. 

In  discussing  amputations  he  has  described  in 
general  certain  methods  of  anaesthesia  in  use  in  his 
time,  and  especially  the  method  by  means  of  inhala- 


296  OLD-TIME  MAKERS  OF  MEDICINE 

tion.  It  would  not  seem  to  us  in  the  modern  time 
that  this  method  would  be  very  successful,  but  there 
is  an  enthusiastic  accord  of  authorities  attesting  that 
operations  were  done  at  this  time  with  the  help  of 
this  inhalant  without  the  infliction  of  pain.  Chauliac 
says: 

"  Some  prescribe  medicaments  which  send  the  pa- 
tient to  sleep,  so  that  the  incision  may  not  be  felt, 
such  as  opium,  the  juice  of  the  morel,  hyoscyamus, 
mandrake,  ivy,  hemlock,  lettuce.  A  new  sponge  is 
soaked  by  them  in  these  juices  and  left  to  dry  in  the 
sun;  and  when  they  have  need  of  it  they  put  this 
sponge  into  warm  water  and  then  hold  it  under  the 
nostrils  of  the  patient  until  he  goes  to  sleep.  Then 
they  perform  the  operation. ' ' 

Many  people  might  be  prone  to  think  that  the 
hospitals  of  Chauliac 's  time  would  not  be  suitable 
for  such  surgical  work  as  he  describes.  It  is,  how- 
ever, only  another  amusing  assumption  of  this  self- 
complacent  age  of  ours  to  think  that  we  were  the 
first  who  ever  made  hospitals  worthy  of  the  name 
and  of  the  great  humanitarian  purpose  they  sub- 
serve. As  a  matter  of  fact,  the  old-time  hospitals 
were  even  better  than  ours  or,  as  a  rule,  better  than 
any  we  had  until  the  present  generation.  In  "  The 
Popes  and  Science,' '  in  the  chapter  on  "  The  Foun- 
dation of  City  Hospitals,' '  I  call  attention  to  the 
fact  that  architects  of  the  present  day  go  back  to 
the  hospitals  of  the  Middle  Ages  in  order  to  find 
the  models  for  hospitals  for  the  modern  times.  Mr. 
Arthur  Dillon,  a  well-known  New  York  architect, 
writing  of  a  hospital  built  at  Tonnerre  in  France,  to- 
ward the  end  of  the  thirteenth  century  (1292),  says: 


GUY  DE  CHAULIAC  297 

' i  It  was  an  admirable  hospital  in  every  way,  and 
it  is  doubtful  if  we  to-day  surpass  it.  It  was  iso- 
lated ;  the  ward  was  separated  from  the  other  build- 
ings ;  it  had  the  advantage  we  so  often  lose  of  being 
but  one  story  high,  and  more  space  was  given  to 
each  patient  than  we  can  now  afford. 

"  The  ventilation  by  the  great  windows  and  ven- 
tilators in  the  ceiling  was  excellent ;  it  was  cheerfully 
lighted ;  and  the  arrangement  of  the  gallery  shielded 
the  patients  from  dazzling  light  and  from  draughts 
from  the  windows  and  afforded  an  easy  means  of 
supervision,  while  the  division  by  the  roofless  low 
partitions  isolated  the  sick  and  obviated  the  depres- 
sion that  comes  from  sight  of  others  in  pain. 

' '  It  was,  moreover,  in  great  contrast  to  the  cheer- 
less white  wards  of  to-day.  The  vaulted  ceiling  was 
very  beautiful;  the  woodwork  was  richly  carved, 
and  the  great  windows  over  the  altars  were  filled 
with  colored  glass.  Altogether  it  was  one  of  the 
best  examples  of  the  best  period  of  Gothic  Archi- 
tecture."1 

The  fine  hospital  thus  described  was  but  one  of 
many.  Virchow,  in  his  article  on  hospitals  quoted  in 
the  same  chapter,  called  attention  to  the  fact  that  in 
the  thirteenth  and  fourteenth  centuries  every  town 
of  five  thousand  or  more  inhabitants  had  its  hospital, 
founded  on  the  model  of  the  great  Santo  Spirito 
Hospital  in  Eome,  and  all  of  them  did  good  work. 
The  surgeons  of  Guy  de  Chauliac's  time  would  in- 
deed find  hospitals  wherever  they  might  be  called  in 
consultation,  even  in  small  towns.  They  were  more 
numerous  in  proportion  to  population  than  our  own 


xSee  picture  of  the  hospital  ward  at  Tonnerre,  in  "  The  Thirteenth 
Greatest  of  Centuries,"  3rd  edit.,  New  York,  1911. 


298  OLD-TIME  MAKERS  OF  MEDICINE 

and,  as  a  rule,  at  least  as  well  organized  as  ours 
were  until  the  last  few  years. 

It  is  no  wonder  that  with  such  a  good  hospital 
organization  excellent  surgery  was  accomplished. 
Hernia  was  Chauliac's  specialty,  and  in  it  his  sur- 
gical judgment  is  admirable  Mondeville  before  his 
time  did  not  hesitate  to  say  that  many  operations 
for  hernia  were  done  not  for  the  benefit  of  the  pa- 
tient, but  for  the  benefit  of  the  surgeon, — a  very 
striking  anticipation  of  remarks  that  one  sometimes 
hears  even  at  the  present  time.  Chauliac  discussed 
operations  for  hernia  very  conservatively.  His  rule 
was  that  a  truss  should  be  worn,  and  no  operation 
attempted  unless  the  patient's  life  was  endangered 
by  the  hernia.  It  is  to  him  that  we  owe  the  inven- 
tion of  a  well-developed  method  of  taxis,  or  manipu- 
lation of  a  hernia,  to  bring  about  its  reduction,  which 
was  in  use  until  the  end  of  the  nineteenth  century. 
He  suggested  that  trusses  could  not  be  made  accord- 
ing to  rule,  but  must  be  adapted  to  each  individual 
case.  He  invented  several  forms  of  truss  himself, 
and  in  general  it  may  be  said  that  his  manipulative 
skill  and  his  power  to  apply  his  mechanical  prin- 
ciples to  his  work  are  the  most  characteristic  of  his 
qualities.  This  is  particularly  noteworthy  in  his 
chapters  on  fractures  and  dislocations,  in  which  he 
suggests  various  methods  of  reduction  and  realizes 
very  practically  the  mechanical  difficulties  that  were 
to  be  encountered  in  the  correction  of  the  deform- 
ities due  to  these  pathological  conditions.  In  a  word, 
we  have  a  picture  of  the  skilled  surgeon  of  the  mod- 
ern time  in  this  treatise  of  a  fourteenth-century 
teacher  of  surgery. 


GUY  BE  CHAULIAC  299 

Chauliac  discusses  six  different  operations  for  the 
radical  cure  of  hernia.  As  Gurlt  points  out,  he 
criticises  them  from  the  same  standpoint  as  that  of 
recent  surgeons.  The  object  of  radical  operations 
for  hernia  is  to  produce  a  strong,  firm  tissue  support 
over  the  ring  through  which  the  cord  passes,  so  that 
the  intestines  cannot  descend  through  it.  It  is 
rather  interesting  to  find  that  the  surgeons  of  this 
time  tried  to  obliterate  the  canal  by  means  of  the 
cautery,  or  inflammation  producing  agents,  arsenic 
and  the  like,  a  practice  that  recalls  some  methods 
still  used  more  or  less  irregularly.  They  also  used 
gold  wire,  which  was  to  be  left  in  the  tissues  and  is 
supposed  to  protect  and  strengthen  the  closure  of 
the  ring.  At  this  time  all  these  operations  for  the 
radical  cure  of  hernia  involved  the  sacrifice  of  the 
testicle  because  the  old  surgeons  wanted  to  obliterate 
the  ring  completely,  and  thought  this  the  easiest 
way.  Chauliac  discusses  the  operation  in  this  re- 
spect and  says  that  he  has  seen  many  cases  in  which 
men  possessed  of  but  one  testicle  have  procreated, 
and  this  is  a  case  where  the  lesser  of  two  evils  is  to 
be  chosen. 

Of  course  Guy  de  Chauliac  would  not  have  been 
able  to  operate  so  freely  on  hernia  and  suggest,  fol- 
lowing his  own  experience,  methods  of  treatment  of 
penetrating  wounds  of  the  abdomen  only  that  he  had 
learned  the  lessons  of  antiseptic  surgery  which  had 
been  gradually  developed  among  the  great  surgeons 
of  Italy  during  the  preceding  century.  The  use  of 
the  stronger  wines  as  a  dressing  together  with  in- 
sistence on  the  most  absolute  cleanliness  of  the  sur- 
geon before  the  operation,  and  careful  details  of 


300  OLD-TIME  MAKERS  OF  MEDICINE 

cleanliness  during  the  operation,  made  possible  the 
performance  of  many  methods  of  surgical  interven- 
tion that  would  otherwise  surely  have  been  fatal. 
Probably  nothing  is  harder  to  understand  than  that 
after  these  practical  discoveries  men  should  have 
lost  sight  of  their  significance,  and  after  having 
carefully  studied  the  viscous  exudation  which  pro- 
duces healthy  natural  union,  should  have  come  to  the 
thought  of  the  necessity  for  the  formation  of  laud- 
able pus  before  union  might  be  expected.  The  mys- 
tery is  really  no  greater  than  that  of  many  another 
similar  incident  in  human  history,  but  it  strikes  us 
more  forcibly  because  the  discovery  and  gradual  de- 
velopment of  antiseptic  surgery  in  our  own  time  has 
meant  so  much  for  us.  Already  even  in  Chauliac's 
practice,  however,  some  of  the  finer  elements  of  the 
technique  that  made  surgery  antiseptic  to  a  marked 
degree,  if  not  positively  aseptic  in  many  cases,  were 
not  being  emphasized  as  they  were  by  his  predeces- 
sors, and  there  was  a  beginning  of  surgical  meddle- 
someness reasserting  itself. 

It  must  not  be  thought,  however,  that  it  was  only 
with  the  coarse  applications  of  surgery  that  Chau- 
liac  concerned  himself.  He  was  very  much  inter- 
ested in  the  surgical  treatment  of  eye  diseases  and 
wrote  a  monograph  on  cataract,  in  which  he  gathers 
what  was  known  before  his  time  and  discusses  it  in 
the  light  of  his  own  experience.  The  writing  of 
such  a  book  is  not  so  surprising  at  this  time  if  we 
recall  that  in  the  preceding  century  the  famous  Pope 
John  XXI,  who  had  been  a  physician  before  he  be- 
came Pope,  and  under  the  name  of  Peter  of  Spain 
was  looked  up  to  as  one  of  the  distinguished  sci- 


GUY  DE  CHAULIAC  301 

entists  of  his  time,  had  written  a  book  on  eye  dis- 
eases that  has  recently  been  the  subject  of  much 
attention. 

Pope  John  had  much  to  say  of  cataract,  dividing 
it  into  traumatic  and  spontaneous,  and  suggesting 
the  needling  of  cataract,  a  gold  needle  being  used 
for  the  purpose.  Chauliac 's  method  of  treating 
cataract  was  by  depression.  His  care  in  the  selec- 
tion of  patients  may  be  appreciated  from  his  treat- 
ment of  John  of  Luxembourg,  King  of  Bavaria, 
blind  from  cataract,  who  consulted  Chauliac  in  1336 
while  on  a  visit  to  Avignon  with  the  King  of  France. 
Chauliac  refused  to  operate,  however,  and  put  off 
the  King  with  dietary  regulations. 

In  the  chapter  on  John  of  Arcoli  and  Medieval 
Dentistry  we  call  attention  to  the  fact  that  Chauliac 
discussed  dental  surgery  briefly,  yet  with  such  prac- 
tical detail  as  to  show  very  clearly  how  much  more 
was  known  about  this  specialty  in  his  time  than  we 
have  had  any  idea  of  until  recent  years.  He  recog- 
nized the  dentists  as  specialists,  calls  them  denta- 
tores,  but  thinks  that  they  should  operate  under  the 
direction  of  a  physician — hence  the  physician  should 
know  much  about  teeth  and  especially  about  their 
preservation.  He  enumerates  instruments  that 
dentists  should  have  and  shows  very  clearly  that  the 
specialty  had  reached  a  high  state  of  development. 
A  typical  example  of  Chauliac's  common  sense  and 
dependence  on  observation  and  not  tradition  is  to 
be  found  in  what  he  has  to  say  with  regard  to 
methods  of  removing  the  teeth  without  the  use  of 
extracting  instruments.  It  is  characteristic  of  his 
method  of  dealing  with  traditional  remedies,  even 


302  OLD-TIME  MAKERS  OF  MEDICINE 

though  of  long  standing,  that  he  brushes  them  aside 
with  some  impatience  if  they  have  not  proved  them- 
selves in  his  experience. 

"  The  ancients  mention  many  medicaments,  which 
draw  out  the  teeth  without  iron  instruments  or  which 
make  them  more  easy  to  draw  out ;  such  as  the  milky 
juice  of  the  tithymal  with  pyrethrum,  the  roots  of 
the  mulberry  and  caper,  citrine  arsenic,  aqua  fortis, 
the  fat  of  forest  frogs.  But  these  remedies  promise 
much  and  accomplish  but  little — mais  Us  donnent 
beaucoup  de  promesses,  et  peu  d' operations." 

It  is  no  wonder  that  Chauliao  has  been  enthusi- 
astically praised.  Nicaise  has  devoutly  gathered 
many  of  these  praises  into  a  sheaf  of  eulogies  at  the 
end  of  his  biography  of  the  great  French  surgeon. 
He  tells  us  that  Fallopius  compared  him  to  Hippoc- 
rates. John  Calvo  of  Valencia,  who  translated  the 
"  Great  Surgery  "  into  Spanish,  looks  upon  him 
as  the  first  law-giver  of  surgery.  Freind,  the  great 
English  physician,  in  1725  called  him  the  Prince 
of  Surgeons.  Ackermann  said  that  Guy  de  Chau- 
liac's  text-book  will  take  the  place  of  all  that  has 
been  written  on  the  subject  down  to  his  time,  so  that 
even  if  all  the  other  works  had  been  lost  his  would 
replace  them.  Dezimeris,  commenting  on  this,  says 
that  "  if  one  should  take  this  appreciation  literally, 
this  surgeon  of  the  fourteenth  century  would  be  the 
first  and,  up  to  the  present  time,  the  only  author 
who  ever  merited  such  an  eulogy. ' '  "At  least, ' '  he 
adds,  ' '  we  cannot  refuse  him  the  distinction  of  hav- 
ing made  a  work  infinitely  superior  to  all  those  which 
appeared  up  to  this  time  and  even  for  a  long  time 
afterwards.    Posterity  rendered  him  this  justice,  for 


GUY  BE  CHAULIAC  303 

he  was  for  three  centuries  the  classic  par  excellence. 
He  rendered  the  stndy  easy  and  profitable,  and  all 
the  foreign  nations  the  tributaries  of  our  country." 
Peyrihle  considered  Guy's  "  Surgery  "  as  the  most 
valuable  and  complete  work  of  all  those  of  the  same 
kind  that  had  been  published  since  Hippocrates  and 
added  that  the  reading  of  it  was  still  useful  in  his 
time  in  1784.  Begin,  in  his  work  on  Ambroise  Pare, 
says  "  that  Guy  has  written  an  immortal  book  to 
which  are  attached  the  destinies  of  French  surgeons." 
Malgaigne,  in  his  "  History  of  Surgery,"  does  not 
hesitate  to  say,  UI  do  not  fear  to  say  that,  Hip- 
pocrates alone  excepted,  there  is  not  a  single  treatise 
on  surgery, — Greek,  Latin,  or  Arabic, — which  I 
place  above,  or  even  on  the  same  level  with,  this 
magnificent  work,  '  The  Surgery  of  Guy  de  Chau- 
liac'  "  Daremberg  said,  "  Guy  seems  to  us  a  sur- 
geon above  all  erudite,  yet  expert  and  without  ever 
being  rash.  He  knows,  above  all,  how  to  choose 
what  is  best  in  everything."  Verneuil,  in  his  "  Con- 
ference sur  Les  Chirurgiens  Erudits,"  says,  "  The 
services  rendered  by  the  '  Great  Surgery  '  were  im- 
mense; by  it  there  commenced  for  France  an  era 
of  splendor.  It  is  with  justice,  then,  that  posterity 
has  decreed  to  Guy  de  Chauliac  the  title  of  Father 
of  French  surgery." 

The  more  one  reads  of  Chauliac's  work  the  less 
is  one  surprised  at  the  estimation  in  which  he  has 
been  held  wherever  known.  It  would  not  be  hard 
to  add  a  further  sheaf  of  compliments  to  those  col- 
lected by  Nicaise.  Modern  writers  on  the  history 
of  medicine  have  all  been  enthusiastic  in  their  ad- 
miration of  him,  just  in  proportion  to  the  thorough- 


304  OLD-TIME  MAKERS  OF  MEDICINE 

ness  of  their  acquaintance  with  him.  Portal,  in  his 
"  History  of  Anatomy  and  Surgery,' '  says, 
"  Finally,  it  may  be  averred  that  Guy  de  Chauliac 
said  nearly  everything  which  modern  surgeons  say, 
and  that  his  work  is  of  infinite  price  but  unfortu- 
nately too  little  read,  too  little  pondered."  Mal- 
gaigne  declares  Chauliac's  "  Chirurgia  Magna  "  to 
be  "  a  masterpiece  of  learned  and  luminous  writ- 
ing." Professor  Clifford  Allbutt,  the  Eegius  Pro- 
fessor of  Physic  at  the  University  of  Cambridge, 
says  of  Chauliac's  treatise:  "  This  great  work  I 
have  studied  carefully  and  not  without  prejudice; 
yet  I  cannot  wonder  that  Fallopius  compared  the 
author  to  Hippocrates  or  that  John  Freind  calls 
him  the  Prince  of  Surgeons.  It  is  rich,  aphoristic, 
orderly,  and  precise. ' ' * 

If  to  this  account  of  his  professional  career  it  be 
added  that  Chauliac 's  personality  is,  if  possible, 
more  interesting  than  his  surgical  accomplishment, 
some  idea  of  the  significance  of  the  life  of  the  great 
father  of  modern  surgery  will  be  realized.  We  have 
already  quoted  the  distinguished  words  of  praise 
accorded  him  by  Pope  Clement  VI.  That  they  were 
well  deserved,  Chauliac's  conduct  during  the  black 
death  which  ravaged  Avignon  in  1348,  shortly  after 
his  arrival  in  the  Papal  City,  would  have  been  suffi- 
cient of  itself  to  attest.  The  occurrence  of  the 
plague  in  a  city  usually  gave  rise  to  an  exhibition 
of  the  most  arrant  cowardice,  and  all  who  could, 
fled.  In  many  of  the  European  cities  the  physicians 
joined  the  fugitives,  and  the  ailing  were  left  to  care 

^'The  Historical  Relations  of  Medicine  and  Surgery,"  by  T.  Clifford 
Allbutt,  M.A.,  M.D.    London:  Macmillan  &  Co.,  Ltd.,  1905. 


GUY  DE  CHAULIAC  305 

for  themselves.  With  a  few  notable  exceptions,  this 
was  the  case  at  Avignon,  but  Guy  was  among  those 
who  remained  faithful  to  his  duty  and  took  on  him- 
self the  self-sacrificing  labor  of  caring  for  the  sick, 
doubly  harassing  because  so  many  of  his  brother 
physicians  were  absent.  He  denounces  their  con- 
duct as  shameful,  yet  does  not  boast  of  his  own 
courage,  but  on  the  contrary  says  that  he  was  in 
constant  fear  of  the  disease.  Toward  the  end  of 
the  epidemic  he  was  attacked  by  the  plague  and 
for  a  time  his  life  was  despaired  of.  Fortunately 
he  recovered,  to  become  the  most  influential  among 
his  colleagues,  the  most  highly  admired  of  the  physi- 
cians of  his  generation,  and  the  close  personal  friend 
of  all  the  high  ecclesiastics,  who  had  witnessed  his 
magnificent  display  of  courage  and  of  helpfulness 
for  the  plague-stricken  during  the  epidemic.  He 
wrote  a  very  clear  account  of  the  epidemic, 
which  leaves  no  doubt  that  it  was  true  bubonic 
plague. 

After  this  fine  example,  Chauliac's  advice  to 
brother  physicians  in  the  specialty  of  surgery  car- 
ried added  weight.  In  the  Introductory  chapter  of 
his  ' '  Chirurgia  Magna  ' '  he  said : 

"  The  surgeon  should  be  learned,  skilled,  in- 
genious, and  of  good  morals.  Be  bold  in  things  that 
are  sure,  cautious  in  dangers;  avoid  evil  cures  and 
practices;  be  gracious  to  the  sick,  obliging  to  his 
colleagues,  wise  in  his  predictions.  Be  chaste,  sober, 
pitiful,  and  merciful;  not  covetous  nor  extortionate 
of  money;  but  let  the  recompense  be  moderate,  ac- 
cording to  the  work,  the  means  of  the  sick,  the  char- 
acter of  the  issue  or  event,  and  its  dignity.' ' 


306  OLD-TIME  MAKERS  OF  MEDICINE 

No  wonder  that  Malgaigne  says  of  him,  "  Never 
since  Hippocrates  has  medicine  heard  snch  language 
filled  with  so  much  nobility  and  so  full  of  matter 
in  so  few  words." 

Chauliac  was  in  every  way  worthy  of  his  great 
contemporaries  and  the  period  in  which  his  lot  was 
cast.  Ordinarily  we  are  not  apt  to  think  of  the 
early  fourteenth  century  as  an  especially  productive 
period  in  human  history,  but  such  it  is.  Dante's 
Divine  Comedy  was  entirely  written  during  Chau- 
liac 's  life.  Petrarch  was  born  within  a  few  years 
of  Chauliac  himself;  Boccaccio  in  Italy,  and  Chaucer 
in  England,  wrote  while  Chauliac  was  still  alive. 
Giotto  did  his  great  painting,  and  his  pupils  were 
laying  the  deep,  firm  foundations  of  modern  art. 
Many  of  the  great  cathedrals  were  being  finished. 
Most  of  the  universities  were  in  the  first  flush  of 
their  success  as  moulders  of  the  human  mind.  There 
are  few  centuries  in  history  that  can  show  the  exist- 
ence of  so  many  men  whose  work  was  to  have  an 
enduring  influence  for  all  the  after  time  as  this 
upon  which  Chauliac's  career  shed  so  bright  a  light. 
The  preceding  century  had  seen  the  origin  of  the 
universities  and  the  rise  of  such  supremely  great 
men  as  Albertus  Magnus,  Eoger  Bacon,  Thomas 
Aquinas,  and  the  other  famous  scholars  of  the  early 
days  of  the  mendicant  orders,  and  had  made  the  in- 
tellectual mould  of  university  training  in  which 
men's  minds  for  seven  centuries  were  to  be  formed, 
so  that  Chauliac,  instead  of  being  an  unusual  phe- 
nomenon is  only  a  fitting  expression  of  the  interest 
of  this  time  in  everything,  including  the  physical 
sciences  and,  above  all,  medicine  and  surgery. 


GUT  DE  CHAULIAC  307 

For  some  people  it  may  be  a  source  of  surprise 
that  Chauliac  should  have  had  the  intellectual  train- 
ing to  enable  him  to  accomplish  such  judicious  work 
in  his  specialty.  Many  people  will  be  apt  to  assume 
that  he  accomplished  what  he  did  in  spite  of  his 
training,  genius  succeeding  even  in  an  unfavorable 
environment,  and  notwithstanding  educational  dis- 
advantages. Those  who  would  be  satisfied  with  any 
such  explanation,  however,  know  nothing  of  the  edu- 
cational opportunities  provided  in  the  period  of 
which  Chauliac  was  the  fruit.  He  is  a  typical  uni- 
versity man  of  the  beginning  o£  the  fourteenth  cen- 
tury, and  the  universities  must  be  given  due  credit 
for  him.  It  is  ordinarily  assumed  that  the  univer- 
sities paid  very  little  attention  to  science  and  that 
scientists  would  find  practically  nothing  to  satisfy 
in  their  curricula.  Professor  Huxley  in  his  address 
on  "  Universities,  Actual  and  Ideal,"  delivered  as 
the  Eectorial  Address  at  Aberdeen  University  in 
1874,  declared  that  they  were  probably  educating  in 
the  real  sense  of  the  word  better  than  we  do  now. 
(See  quotation  in  "  The  Medical  School  at 
Salerno.") 

In  the  light  of  Chauliac 's  life  it  is  indeed  amusing 
to  read  the  excursions  of  certain  historians  into  the 
relationship  of  the  Popes  and  the  Church  to  science 
during  the  Middle  Ages.  Chauliac  is  typically  rep- 
resentative of  medieval  science,  a  man  who  gave  due 
weight  to  authority,  yet  tried  everything  by  his 
own  experience,  and  who  sums  up  in  himself  such 
wonderful  advance  in  surgery  that  during  the  last 
twenty  years  the  students  of  the  history  of  medicine 


308  OLD-TIME  MAKERS  OF  MEDICINE 

have  been  more  interested  in  him  than  in  anyone 
who  comes  during  the  intervening  six  centuries. 
Chauliac,  however,  instead  of  meeting  with  any  op- 
position, encountered  encouragement,  liberal  patron- 
age, generous  interest,  and  even  enjoyed  the  inti- 
mate friendship  of  the  highest  ecclesiastics  and  the 
Popes  of  his  time.  In  every  way  his  life  may  be 
taken  as  a  type  of  what  we  have  come  to  know  about 
the  Middle  Ages,  when  we  know  them  as  we  should, 
in  the  lives  of  the  men  who  counted  for  most  in 
them,  and  do  not  accept  merely  the  broad  general- 
izations which  are  always  likely  to  be  deceptive  and 
which  in  the  past  have  led  men  into  the  most  absurd 
and  ridiculous  notions  with  regard  to  a  wonderful 
period  in  human  history. 

That  Guy  de  Chauliac  was  no  narrow  specialist 
is  abundantly  evident  from  his  book,  for  while  the 
"  Great  Surgery  "  treats  of  the  science  and  art  of 
surgery  as  its  principal  subject,  there  are  remarks 
about  nearly  everything  else  relating  to  medicine, 
and  most  of  them  show  a  deep  interest,  a  thorough 
familiarity,  and  an  excellent  judgment.  Besides  we 
have  certain  expressions  with  regard  to  intellectual 
matters  generally  which  serve  to  show  Guy  as  a  pro- 
found thinker,  who  thoroughly  appreciated  just  how 
accumulations  of  knowledge  came  to  men  and  how 
far  each  generation  or  member  of  a  generation 
should  go  and  yet  how  limited  must,  after  all,  be 
the  knowledge  obtained  by  any  one  person.  With 
regard  to  books,  for  instance,  he  said,  "  for  every- 
one cannot  have  all  the  books,  and  even  if  he  did 
have  them  it  would  be  too  tiresome  to  read  them  all 


GUT  DE  CHAULIAC  309 

and  completely,  and  it  would  require  a  godlike 
memory  to  retain  them  all."  He  realized,  however, 
that  each  generation,  provided  it  took  the  oppor- 
tunities offered  it,  was  able  to  see  a  little  bit  farther 
than  its  predecessor,  and  the  figure  that  he  employs 
to  express  this  is  rather  striking.  "  Sciences,"  he 
said,  "  are  made  by  additions.  It  is  quite  impossible 
that  the  man  who  begins  a  science  should  finish  it. 
We  are  like  infants,  clinging  to  the  neck  of  a  giant ; 
for  we  can  see  all  the  giant  sees  and  a  little  more." 

One  of  the  most  interesting  features  of  the  history 
of  Guy  de  Chauliac  is  the  bibliography  of  his  works 
which  has  been  written  by  Nicaise.  This  is  ad- 
mirably complete,  labored  over  with  the  devotion 
that  characterized  Nicaise 's  attitude  of  unstinted 
admiration  for  the  subject.  Altogether  he  has  some 
sixty  pages  of  a  quarto  volume  with  regard  to  the 
various  editions  of  Guy's  works. 

The  first  manuscript  edition  of  Guy  de  Chauliac 
was  issued  in  1363,  the  first  printed  edition  in  1478. 
Even  in  the  fourteenth  century  Guy's  great  work 
was  translated  into  all  the  languages  generally  used 
in  Europe.  Nicaise  succeeded  in  placing  34  com- 
plete manuscripts  of  the  ' '  Great  Surgery  " :  22  of 
these  are  in  Latin,  4  are  in  French,  3  are  in  English, 
2  only  in  Provencal,  though  that  was  the  language 
spoken  in  the  region  where  much  of  Chauliac 's  life 
was  passed,  and  one  each  in  Italian,  in  Low  Dutch, 
and  in  Hebrew.  Of  the  English  manuscripts,  one  is 
number  twenty-five  English  of  the  Bibliotheque 
Nationale,  Paris;  a  second  is  number  3666  English 
of  the  Sloane  collection  in  the  British  Museum,  and 


310  OLD-TIME  MAKERS  OF  MEDICINE 

a  third  is  in  the  Library  of  the  University  of  Cam- 
bridge.1 

Paulin  Paris,  probably  one  of  the  best  of  recent 
authorities  on  the  age  and  significance  of  old  manu- 
scripts, says  in  the  third  volume  of  his  '  Manuscrits 
Frangais,"  page  346,  "  This  manuscript  [of  Guy 
de  Chauliac's  "  Great  Surgery  "]  was  made,  if  not 
during  the  life,  then  certainly  very  shortly  after  the 
death  of  the  author.  It  is  one  of  the  oldest  that  can 
be  cited,  and  the  fact  that  an  English  translation 
was  made  so  near  to  the  time  of  the  original  com- 
position of  the  book  attests  the  great  reputation 
enjoyed  by  Guy  de  Chauliac  at  this  time,  and  which 
posterity  has  fully  confirmed. ' ' 

The  Sloane  copy  in  the  British  Museum  contains 

1  The  beginning  of  the  manuscript  copy  in  the  ' '  Bibliotheque  Natio- 
nale  "  is  extremely  interesting  as  an  example  of  the  English  of  the  period, 
and  alongside  of  it  it  seems  worth  while  to  quote  the  closing  sentence 
as  Nicaise  reproduces  them  ; 

"In  godes  name  here  bygyneth  the  inventarie  of  gadryng  to  gedre 
medecyne  in  the  partye  of  cyrurgie  compilede  and  fulfilled  in  the  zere 
(yere?)  of  our  Loord  1363  by  Guide  de  Cauliaco  cirurgene  and  doctor 
of  physik  in  the  f  ulclere  studye  of  Mountpylerz. 

"  On  page  191,  verso.— Here  endeth  the  cyrurgie  of  Maistre  Guyd'  de 
Cauliaco  dottoure  of  phisik." 

The  University  of  Cambridge  copy  has  the  title  in  the  colophon.  It 
runs  as  follows:  "Ye  inventory e  of  Guydo  de  Caulhiaco  Doctor  of 
Phisyk  and  Cirurgien  in  Ye  Universitie  of  Mount  Pessulanee  of  Mont- 
peleres."  The  fly-leaf  contains  the  words,  "  Jesu  Christ  save  ye  soule 
of  mien.'  It  is  rather  interesting  to  note  how  much  closer  to  modern 
English  is  this  copy,  made  probably  not  much  more  than  half  a  century 
later  than  the  first  one  and,  above  all,  how  much  more  nearly  the  spell- 
ing has  come.  At  this  time,  however,  and,  indeed,  for  more  than  a 
century  later,  spelling  had  no  fixed  rule,  and  a  man  might  spell  the 
same  word  quite  differently  even  on  the  same  page.  The  difference 
between  doctor  spelled  thus  in  the  early  edition,  and  doctours  in  the 
later  one,  probably  means  nothing  more  than  personal  peculiarities  of 
the  original  translator  or  copyist. 


GUY  BE  CHAULIAC  311 

some  medical  recipes  at  the  end  by  Francis  Verney. 
It  was  probably  written  in  the  fifteenth  century. 
Its  title  is : 

"  The  inventorie  or  the  collectorie  in  cirnrgicale 
parte  of  medicine  compiled  and  complete  in  the  yere 
of  onr  Lord  1363,  with  some  additions  of  other  doc- 
tours,  necessary  to  the  foresaid  arte  or  crapte 
(crafte?)."1 

What  we  find  in  the  period  of  manuscripts,  how- 
ever, is  as  nothing  compared  to  the  prestige  of  Guy 
de  Chauliac's  work,  once  the  age  of  printing  began. 
Nicaise  was  able  to  find  sixty  different  printed  edi- 
tions of  the  ' '  Great  Surgery. ? '  Nine  others  that  are 
mentioned  by  authors  have  disappeared  and  ap- 
parently no  copies  of  them  are  in  existence.  Besides 
there  are  sixty  editions  of  portions  of  the  work,  of 
compendiums  of  it  and  commentaries  on  it.  Alto- 
gether 129  editions  are  extant.  Of  these  there  are 
sixteen  Latin  editions,  forty-three  French,  five 
Italian,  four  Low  Dutch,  five  Catalan,  and  one  Eng- 
lish. Fourteen  appeared  in  the  fifteenth  century, 
thirty-eight  in  the  sixteenth  century,  and  seventeen 
in  the  seventeenth  century.  The  fourteen  editions 
belonging  to  the  incunabula  of  printing,  issued,  that 
is,  before  the  end  of  the  fifteenth  century,  show  what 
lively  interest  there  was  in  the  French  surgeon  of 
the  preceding  century,  since  printing  presses  at  this 
precious  time  were  occupied  only  with  the  books  that 

1  In  Nicaise  this  last  word  is  written  crapte.  I  have  ventured  to 
suggest  crafte,  since  a  misreading  between  the  two  letters  would  be 
so  easy.  In  the  same  way  I  have  suggested  tentatively  a  changing 
of  the  z  in  the  title  of  the  Bibliotheque  Nationale  copy  to  y,  mak- 
ing the  word  yere  instead  of  zere. 


312  OLD-TIME  MAKEBS  OF  MEDICINE 

were  considered  indispensable  for  scholars.  The 
first  edition  of  the  ' '  Great  Surgery  ' '  was  printed  in 
1478  at  Lyons.  Printing  had  only  been  introduced 
there  five  years  before.  This  first  edition,  primus 
primarius  or  editio  princeps,  was  a  French  transla- 
tion by  Nicholas  Panis.  In  1480  an  Italian  edition 
was  printed  at  Venice.  The  first  Latin  edition  was 
printed  also  in  Venice  in  1490. 

It  would  be  only  natural  to  expect  that  the  suc- 
cessors of  Guy  de  Chauliac,  and  especially  those  who 
had  come  personally  in  contact  with  him,  would  take 
advantage  of  his  thorough  work  to  make  still  fur- 
ther advances  in  surgery.  As  matter  of  fact,  de- 
cadence in  surgery  is  noted  immediately  after  his 
death.  Three  men  taught  at  the  University  of 
Montpellier  at  the  end  of  the  fourteenth  and  the  be- 
ginning of  the  fifteenth  century,  John  de  Tornamira, 
Valesco  de  Taranta,  and  John  Faucon.  They  can- 
not be  compared,  Gurlt  says,  with  Guy  de  Chauliac, 
though  they  were  physicians  of  reputation  in  their 
time.  Faucon  made  a  compendium  of  Guy's  work 
for  students.  Somehow  there  seemed  to  be  the  im- 
pression that  surgery  had  now  reached  a  point  of 
development  beyond  which  it  could  not  advance. 
Unfortunate  political  conditions,  wars,  the  with- 
drawal of  the  Popes  from  Avignon  to  Eome,  and 
other  disturbances,  distracted  men's  minds,  and 
surgery  deteriorated  to  a  considerable  extent,  until 
the  new  spirit  at  the  time  of  the  Eenaissance  came 
to  inject  fresh  life  into  it. 


XII 


MEDIEVAL  DENTISTRY— GIOVANNI  OF 

AECOLL 

If  there  is  one  phase  of  our  present-day  medicine 
and  surgery  that  most  of  us  are  likely  to  be  quite 
sure  is  of  very  recent  development  it  is  dentistry. 
Probably  most  people  would  declare  at  once  that 
they  had  every  reason  to  think  that  the  science  and 
art  of  dentistry,  as  we  have  it  now,  developed  for 
the  first  time  in  the  world's  history  during  the  last 
generation  or  two.  It  is  extremely  interesting  to 
realize  then,  in  the  light  of  this  almost  universal 
persuasion,  founded  to  a  great  extent  on  the  con- 
viction that  man  is  in  process  of  evolution  and  that 
as  a  consequence  we  must  surely  be  doing  things 
now  that  men  never  did  before,  to  find  that  dentistry, 
both  as  an  art  and  science,  is  old ;  that  it  has  devel- 
oped at  a  number  of  times  in  the  world's  history, 
and  that  as  fortunately  for  history  its  work  was 
done  mainly  in  indestructible  materials,  the  teeth 
themselves  and  metal  prosthetic  apparatus,  we  have 
actual  specimens  of  what  was  accomplished  at  a  num- 
ber of  periods  in  the  olden  times.  Surprising  as  it 
will  seem  to  those  who  hear  of  it  for  the  first  time, 
dentistry  reached  high  perfection  even  in  what  we 
know  as  ancient  history.  It  is  rather  easy  to  trace 
scientific  and  craftsmanlike  interest  in  it  during  the 

313 


314  OLD-TIME  MAKERS  OF  MEDICINE 

medieval  period  and  in  the  magnificent  development 
of  surgery  that  came  just  at  the  end  of  the  Middle 
Ages,  dentistry  shared  to  such  degree  that  some  of 
the  text-books  of  the  writers  on  surgery  of  this  time 
furnish  abundant  evidence  of  anticipations  of  many 
of  the  supposedly  most  modern  developments  of  den- 
tistry. 

There  are  a  number  of  historical  traditions  with 
regard  to  dentistry  and  the  treatment  of  the  teeth  in 
Egypt  that  can  be  traced  back  to  good  authorities 
in  Egyptology  of  a  generation  or  more  ago,  but  it  is 
rather  hard  to  confirm  the  accounts  we  have  by 
actual  specimens;  either  none  were  found  or  for 
some  reason  those  actually  discovered  are  now  not 
readily  available  for  study.  Among  the  Phenicians 
however,  though  we  have  good  reasons  to  think  that 
they  learned  their  arts  and  crafts  from  the  Egyp- 
tians, there  is  convincing  evidence  of  a  high  develop- 
ment of  dentistry.  M.  Ernest  Eenan,  during  an  ex- 
ploring expedition  in  Phenicia,  found  in  the  old 
necropolis  at  Sidon  a  set  of  teeth  wired  together,  two 
of  which  were  artificial.  It  was  a  striking  example 
of  bridgework,  very  well  done,  and  may  now  be  seen 
in  the  Louvre.  It  would  be  more  than  a  little  surpris- 
ing, from  what  we  know  of  the  lack  of  inventiveness 
on  the  part  of  the  Phenicians  and  their  tendency 
to  acquire  their  arts  by  imitation,  if  they  had  reached 
such  a  climax  of  invention  by  themselves.  Since 
they  adapted  and  adopted  most  of  their  arts  and 
crafts  from  Egypt,  with  which  they  were  in  close 
commercial  relations,  it  has  been  argued  with  some 
plausibility  that  the  Egyptians  may  have  had  many 
modes  of  dental  prosthesis,  but  removed  all  artificial 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ABCOLI     315 

teeth  and  dental  appliances  from  the  month  of 
corpses  before  embalming  them,  in  preparation  for 
the  next  world,  because  there  was  some  reli- 
gious objection  to  snch  human  handiwork  being 
left  in  place  for  the  hereafter,  as  they  hoped 
for  it. 

There  is  a  well-authenticated  tradition  of  intimate 
intercourse  in  a  commercial  way  between  the  old 
Etruscans  who  inhabited  the  Italian  hill  country  and 
the  Phenicians,  so  that  it  is  no  surprise  to  find  that 
the  oldest  of  Etruscan  tombs  contain  some  fine  ex- 
amples of  bridge  work.  An  improvement  has  come 
over  Phenician  work  however,  and  bands  of  gold 
instead  of  wire  are  used  for  holding  artificial  teeth 
in  place.  Guerini,  whose  "  History  of  Dentistry  " 
is  the  standard  work  on  the  subject,  on  a  commission 
from  the  Italian  government,  carefully  studied  these 
specimens  of  Etruscan  dental  work  in  the  museums 
of  Italy,  and  has  made  some  interesting  observa- 
tions on  them.  In  one  specimen,  which  is  espe- 
cially notable,  two  incisor  teeth  are  replaced  by  a 
single  tooth  from  a  calf.  This  was  grooved  in  such 
a  way  as  to  make  it  seem  like  two  separate  teeth. 
Guerini  suggests  a  very  interesting  and  quite  unex- 
pected source  for  this.  While  examining  the  speci- 
men he  wondered  where  the  old  Etruscan  dentist 
had  obtained  a  calf's  tooth  without  a  trace  of  wear 
on  it.  He  came  to  the  conclusion  that  he  must  have 
cut  into  the  gums  of  a  young  calf  before  the  per- 
manent tooth  was  erupted  in  order  to  get  this  struc- 
ture absolutely  unworn  for  his  purpose.  A  number 
of  examples  of  bridgework  have  been  found  in  the 
old  Etruscan  tombs.     The  dates  of  their  construe- 


316  OLD-TIME  MAKERS  OF  MEDICINE 

tion  are  probably  not  later  than  500  b.c.,  and  some 
of  them  are  perhaps  earlier  than  700  b.c. 

The  Etruscans  affected  the  old  Eomans  in  the  mat- 
ter of  dentistry,  so  that  it  is  easy  to  understand  the 
passage  in  the  "  Laws  of  the  Twelve  Tables,"  issued 
about  450  b.c,  which,  while  forbidding  the  burial  of 
gold  with  corpses,  made  a  special  exception  for  such 
gold  as  was  fastened  to  the  teeth.  Gold  was  rare 
at  Eome,  and  care  was  exercised  not  to  allow  any 
unnecessary  decrease  of  the  visible  supply  almost  in 
the  same  way  as  governments  now  protect  their  gold 
reserves.  It  may  seem  like  comparing  little  things 
with  great,  but  the  underlying  principle  is  the  same. 
Hence  this  special  law  and  its  quite  natural  excep- 
tion. 

In  Pope  Julius'  Museum  in  Eome  there  is  a  speci- 
men of  a  gold  cap  made  of  two  plates  of  gold  riveted 
together  and  also  riveted  to  bands  of  metal  which 
were  fastened  around  the  neighboring  teeth  in  order 
to  hold  the  cap  in  place.  This  is  from  later  Eepub- 
lican  times  at  Eome.  At  the  end  of  the  Eepublic 
and  the  beginning  of  the  Empire  there  appear  to 
have  been  many  forms  of  dental  appliances.  Martial 
says  that  the  reason  why  one  lady's  teeth — whose 
name  he  does  not  conceal— are  white  and  another's 
— name  also  given — were  dark,  was  that  the  first 
one  bought  hers  and  the  second  still  had  her 
own.  In  another  satiric  poem  he  describes  an  elderly 
woman  as  so  much  frightened  that  when  she  ran 
away  her  teeth  fell  out,  while  her  friends  lost  their 
false  hair.  Fillings  of  many  kinds  were  used,  den- 
trifices  of  nearly  every  kind  were  invented,  and  den- 
tistry evidently  reached  a  high  stage  of  development, 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ARCOLI     317 

though  we  have  nowhere  a  special  name  for  dentist, 
and  the  work  seems  to  have  been  done  by  physicians, 
who  took  this  as  a  specialty. 

While  in  the  Middle  Ages  there  was,  owing  to  con- 
ditions, a  loss  of  much  of  this  knowledge  of  antiquity 
with  regard  to  dentistry,  or  an  obscuration  of  it,  it 
never  disappeared  completely,  and  whenever  men 
have  written  seriously  about  medicine,  above  all 
about  surgery  in  relation  to  the  face  and  the  mouth, 
the  teeth  have  come  in  for  their  share  of  scientific 
and  practical  consideration.  Aetius,  the  first  impor- 
tant Christian  writer  on  medicine  and  surgery,  dis- 
cusses, as  we  have  seen  in  the  sketch  of  him,  the 
nutrition  of  the  teeth,  their  nerves,  "  which  came 
from  the  third  pair  and  entered  the  teeth  by  a  small 
hole  existing  at  the  end  of  the  root,''  and  other  in- 
teresting details  of  anatomy  and  physiology.  He 
knows  much  about  the  hygiene  of  the  teeth,  discusses 
extraction  and  the  cure  of  fistula  and  other  details. 
Paul  of  iE'gina  in  the  next  century  has  much  more, 
and  while  they  both  quote  mainly  from  older  authors 
there  seems  no  doubt  that  they  themselves  had  made 
not  a  few  observations  and  had  practical  experience. 

It  was  from  these  men  that  the  Arabian  physicians 
and  surgeons  obtained  their  traditions  of  medicine, 
and  so  it  is  not  surprising  to  find  that  they  discuss 
dental  diseases  and  their  treatment  rationally  and 
in  considerable  detail.  Abulcasis  particularly  has 
much  that  is  of  significance  and  interest.  We  have 
pictures  of  two  score  of  dental  instruments  that  were 
used  by  them.  The  Arabs  not  only  treated  and  filled 
carious  teeth  and  even  replaced  those  that  were 
lost,  but  they  also  corrected  deformities  of  the  mouth 


318  OLD-TIME  MAKERS  OF  MEDICINE 

and  of  the  dental  arches.  Orthodontia  is  sometimes 
said  to  be  of  much  later  origin  and  to  begin  many 
centuries  after  Abulcasis'  time,  yet  no  one  who 
knows  of  his  work  can  speak  of  Orthodontia  as  an 
invention  after  him.  In  this,  however,  as  in  most  of 
the  departments  of  medicine  and  surgery,  the  Arabs 
were  merely  imitators,  though  probably  they  ex- 
panded somewhat  the  practical  knowledge  that  had 
come  to  them. 

When  the  great  revival  in  surgery  came  in  the 
twelfth  and  thirteenth  centuries  it  is  not  surprising 
that  there  should  also  have  been  an  important  re- 
newal of  interest  in  dentistry.  A  detailed  review 
of  this  would  take  us  too  far  afield,  but  at  least 
something  may  be  said  of  two  or  three  of  the  great 
representative  surgical  writers  who  touched  on  this 
specialty. 

About  the  middle  of  the  fourteenth  century  that 
prince  of  surgeons,  and  model  of  surgical  writers, 
Guy  de  Chauliac,  wrote  his  great  text-book  of  sur- 
gery, ' '  Le  Grande  Chirurgie. '  •  An  extremely  inter- 
esting feature  of  this  work  is  to  be  found  in  the 
chapters  that  treat  of  diseases  of  the  teeth.  These 
are  not  very  comprehensive,  and  are  evidently  not 
so  much  the  result  of  his  experience,  as  the  fruit 
of  his  reading,  yet  they  contain  many  practical  valua- 
ble ideas  that  are  supposed  to  be  ever  so  much 
later  than  the  middle  of  the  fourteenth  century. 
His  anatomy  and  physiology  at  least  are  not  without 
many  errors.  His  rules  for  the  preservation  of  the 
teeth  show  that  the  ordinary  causes  of  dental  decay 
were  well  recognized  even  as  early  as  this.  Emphasis 
was  laid  on  not  taking  foods  too  hot  or  too  cold,  and 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ABCOLI     319 

above  all  not  to  follow  either  hot  or  cold  food  by 
something  very  different  from  it  in  temperature. 
The  breaking  of  hard  things  with  the  teeth  was 
recognized  as  one  of  the  most  frequent  causes  of 
such  deterioration  of  the  enamel  as  gives  oppor- 
tunity for  the  development  of  decay.  The  eating 
of  sweets,  and  especially  the  sticky  sweets — pre- 
serves and  the  like — was  recognized  as  an  important 
source  of  caries.  The  teeth  were  supposed  to  be 
cleaned  frequently,  and  not  to  be  cleaned  too  roughly, 
for  this  would  do  more  harm  than  good.  We  find 
these  rules  repeated  by  succeeding  writers  on  gen- 
eral surgery,  who  touch  upon  dentistry,  or  at  least 
the  care  of  the  teeth,  and  they  were  not  original 
with  Guy  de  Chauliac,  but  part  of  the  tradition  of 
surgery. 

As  noted  by  Ghierini  in  his  "  History  of  Den- 
tistry,' '  the  translation  of  which  was  published  under 
the  auspices  of  the  National  Dental  Association  of 
the  United  States  of  America,1  Chauliac  recognized 
the  dentists  as  specialists.  Besides,  it  should  be 
added,  as  is  evident  from  his  enumeration  of  the  sur- 
gical instruments  which  he  declares  necessary  for 
them,  they  were  not  as  we  might  easily  think  in  the 
modern  time  mere  tooth  pullers,  but  at  least  the  best 
among  them  treated  teeth  as  far  as  their  limited 
knowledge  and  means  at  command  enabled  them  to 
do  so,  and  these  means  were  much  more  elaborate 
than  we  have  been  led  to  think,  and  much  more  de- 


1<VA  History  of  Dentistry  from  the  Most  Ancient  Times  Until  the 
End  of  the  Eighteenth  Century,"  by  Dr.  Vincenzo  Guerini,  editor  of  the 
Italian  Review  L'Odonto-Stomatologia,  Philadelphia  and  New  York,  Lea 
and  Febriger,  1909. 


320  OLD-TIME  MAKERS  OF  MEDICINE 

tailed  than  we  have  reason  to  know  that  they  were  at 
certain  subsequent  periods. 

In  fact,  though  G-uy  de  Chauliac  frankly  confesses 
that  he  touches  on  the  subject  of  dentistry  only  in 
order  to  complete  his  presentation  of  the  subject  of 
surgery  and  not  because  he  has  anything  of  his  own 
to  say  with  regard  to  the  subject,  there  is  much  that 
is  of  present-day  interest  in  his  brief  paragraphs. 
He  observes  that  operations  on  the  teeth  are  special 
and  belong  to  the  dentatores,  or  dentists,  to  whom 
doctors  had  given  them  over.  He  considers,  how- 
ever, that  the  operations  in  the  mouth  should  be  per- 
formed under  the  direction  of  a  physician.  It  is  in 
order  to  give  physicians  the  general  principles  with 
which  they  may  be  able  to  judge  of  the  advisability 
or  necessity  for  dental  operations  that  his  short 
chapters  are  written.  If  their  advice  is  to  be  of 
value,  physicians  should  know  the  various  methods 
of  treatment  suitable  for  dental  diseases,  including 
mouth  washes,  gargles,  masticatories,  anointments, 
rubbings,  fumigations,  cauterizations,  fillings,  filings, 
and  the  various  manual  operations.  He  says  that 
the  dentator  must  be  provided  with  the  appropriate 
instruments,  among  which  he  names  scrapers,  rasps, 
straight  and  curved  spatumina,  elevators,  simple  and 
with  two  branches,  toothed  tenacula,  and  many  dif- 
ferent forms  of  probes  and  canulas.  He  should  also 
have  small  scalpels,  tooth  trephines,  and  files. 

Chauliac  is  particularly  emphatic  in  his  insistence 
on  not  permitting  alimentary  materials  to  remain 
in  cavities,  and  suggests  that  if  cavities  between 
the  teeth  tend  to  retain  food  material  they  should 
even  be  filed  in  such  a  way  as  to  prevent  these 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  AUGOLI     321 

accumulations.  His  directions  for  cleansing  the 
teeth  were  rather  detailed.  His  favorite  treatment 
for  wounds  was  wine,  and  he  knew  that  he  suc- 
ceeded by  means  of  it  in  securing  union  by  first 
intention.  It  is  not  surprising,  then,  to  find  that  he 
recommends  rinsing  of  the  mouth  with  wine  as  a 
precaution  against  dental  decay.  A  vinous  decoction 
of  wild  mint  and  of  pepper  he  considered  particularly 
beneficial,  though  he  thought  that  dentifrices,  either 
powder  or  liquid,  should  also  be  used.  He  seems 
to  recommend  the  powder  dentifrices  as  more  effica- 
cious. His  favorite  prescription  for  a  tooth  powder, 
while  more  elaborate,  resembles  to  such  an  extent, 
at  least  some,  if  not  indeed  most  of  those,  that 
are  used  at  the  present  time,  that  it  seems  worth 
while  giving  his  directions  for  it.  He  took  equal 
parts  of  cuttle  bone,  small  white  sea-shells,  pumice 
stone,  burnt  stag's  horn,  nitre,  alum,  rock  salt,  burnt 
roots  of  iris,  aristolochia,  and  reeds.  All  of  these 
substances  should  be  carefully  reduced  to  powder 
and  then  mixed.  His  favorite  liquid  dentifrice  con- 
tained the  following  ingredients, — half  a  pound  each 
of  sal  ammoniac  and  rock  salt,  and  a  quarter  of  a 
pound  of  sacharin  alum.  All  these  were  to  be  re- 
duced to  powder  and  placed  in  a  glass  alembic  and 
dissolved.  The  teeth  should  be  rubbed  with  it,  using 
a  little  scarlet  cloth  for  the  purpose.  Just  why  this 
particular  color  of  cleansing  cloth  was  recommended 
is  not  quite  clear. 

He  recognized,  however,  that  cleansing  of  the  teeth 
properly  often  became  impossible  by  any  scrubbing 
method,  no  matter  what  the  dentifrice  used,  because 
of  the  presence  of  what  we  call  tartar  and  what  he 


322  OLD-TIME  MAKERS  OF  MEDICINE 

called  hardened  limosity  or  limyness  (limosite  en- 
durcie).  When  that  condition  is  present  he  suggests 
the  use  of  rasps  and  spatumina  and  other  instru- 
mental means  of  removing  the  tartar. 

Evidently  he  did  not  believe  in  the  removal  of 
the  teeth  unless  this  was  absolutely  necessary  and 
no  other  method  of  treatment  would  avail  to  save 
the  patient  from  continuous  distress.  He  summar- 
izes the  authorities  with  regard  to  the  extraction  of 
teeth  and  the  removal  of  dental  fragments  and  roots. 
He  evidently  knew  of  the  many  methods  suggested 
before  his  time  of  removing  teeth  without  recourse 
to  instrumental  extraction.  There  were  a  number 
of  applications  to  the  gums  that  were  claimed  by 
older  authors  to  remove  the  teeth  without  the  need 
of  metal  instruments.  We  might  expect  that  Chau- 
liac  would  detect  the  fallacy  with  regard  to  these 
and  expose  it.  He  says  that  while  much  is  claimed 
for  these  methods  he  has  never  seen  them  work  in 
practice  and  he  distrusts  them  entirely. 

The  most  interesting  phase  of  what  Guy  de  Chau- 
liac  has  to  say  with  regard  to  dentistry  is  of  course 
to  be  found  in  his  paragraphs  on  the  artificial  re- 
placement of  lost  teeth  and  the  subject  of  dental 
prosthesis  generally.  When  teeth  become  loose  he 
advises  that  they  be  fastened  to  the  healthy  ones 
with  a  gold  chain.  Guerini  suggests  that  he  evi- 
dently means  a  gold  wire.  If  the  teeth  fall  out  they 
may  be  replaced  by  the  teeth  of  another  person  or 
with  artificial  teeth  made  from  oxbone,  which  may 
be  fixed  in  place  by  a  fine  metal  ligature.  He  says 
that  such  teeth  may  be  serviceable  for  a  long  while. 
This  is  a  rather  curt  way  of  treating  so  large  a 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ARCOLI     323 

subject  as  dental  prosthesis,  but  it  contains  a  lot  of 
suggestive  material.  He  was  quoting  mainly  the 
Arabian  authors,  and  especially  Abulcasis  and  Ali 
Abbas  and  Ehazes,  and  these  of  course,  as  we  have 
said,  mentioned  many  methods  of  artificially  replac- 
ing teeth  as  also  of  transplantation  and  of  treat- 
ment of  the  deformities  of  the  dental  arches. 

On  the  whole,  however,  it  must  be  confessed  that 
we  have  here  in  the  middle  of  the  fourteenth  century 
a  rather  surprising  anticipation  of  the  knowledge  of 
a  special  department  of  medicine  which  is  usually 
considered  to  be  distinctly  modern,  and  indeed  as 
having  only  attracted  attention  seriously  in  com- 
paratively recent  times. 

After  Guy  de  Chauliac  the  next  important  con- 
tributor to  dentistry  is  Giovanni  of  Arcoli,  often 
better  known  by  his  Latin  name,  Johannes  Arcu- 
lanus,  who  was  a  professor  of  medicine  and  surgery 
at  Bologna  and  afterwards  at  Padua,  just  before 
and  after  the  middle  of  the  fifteenth  century,  and 
who  died  in  1484.  He  is  famous  principally  for  be- 
ing the  first  we  know  who  mentions  the  filling  of 
teeth  with  gold. 

It  might  possibly  be  suggested  that  coming  at  this 
time  Arculanus  should  rather  be  reckoned  as  a  Maker 
of  Medicine  in  the  Renaissance  than  as  belonging  to 
the  Middle  Ages  and  its  influences.  His  education, 
however,  was  entirely  completed  before  the  earliest 
date  at  which  the  Eenaissance  movement  is  usually 
said  to  begin,  that  is  with  the  fall  of  Constantinople 
in  1452,  and  he  was  dead  before  the  other  date,  that 
of  the  discovery  of  America  in  1492,  which  the 
Germans  have  in  recent  years  come  to  set  down  as 


324  OLD-TIME  MAKERS  OF  MEDICINE 

the  end  of  the  Middle  Ages.  Besides,  what  he  has 
to  say  about  dentistry  occurs  in  typical  medieval 
form.  It  is  found  in  a  commentary  on  Ehazes, 
written  just  about  the  middle  of  the  fifteenth  cen- 
tury. In  the  later  true  Eenaissance  such  a  com- 
mentary would  have  been  on  a  Greek  author.  In  his 
commentary  Arculanus  touches  on  most  of  the 
features  of  medicine  and  surgery  from  the  stand- 
point of  his  own  experience  as  well  as  from  what 
he  knows  of  the  writings  of  his  predecessors  and 
contemporaries.  With  the  rest  he  has  a  series  of 
chapters  on  diseases  of  the  teeth.  Guerini  in  his 
"  History  of  Dentistry  "  says  that  "  this  subject 
[dentistry]  is  treated  rather  fully,  and  with  great 
accuracy.' '  Even  some  short  references  to  it  will, 
I  think,  demonstrate  this  rather  readily.1 

Arculanus  is  particularly  full  in  his  directions 
for  the  preservation  of  the  teeth.  We  are  rather 
prone  to  think  that  prophylaxis  is  comparatively  a 
modern  idea,  and  that  most  of  the  principles  of 
conservation  of  human  tissues  and  the  prevention 
of  deterioration  and  disease  are  distinctly  modern. 
It  needs  only  a  little  consideration  of  Arculanus'  in- 
struction in  the  matter  of  the  teeth,  however,  to 
undo  any  such  false  impression.  For  obvious 
reasons  I  prefer  to  quote  Guerini 's  summation  of 
this  medieval  student  of  dentistry's  rules  for  dental 
hygiene : 

"  For  the  preservation  of  teeth — considered  by 
him,  quite  rightly,  a  matter  of  great  importance — 

xThe  first  printed  edition  of  Arculanus  is  that  of  Venice,  1542, 
bearing  the  Latin  title,  "  Joannis  Arculani  Commentaria  in  Nonum 
Librum  Rasis,"  etc. 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ARCOLI     325 

Giovanni  of  Arcoli  repeats  the  various  counsels 
given  on  the  subject  by  preceding  writers,  but  he 
gives  them  as  ten  distinct  canons  or  rules,  creating 
in  this  way  a  kind  of  decalogue  of  dental  hygiene. 
These  rules  are :  (1)  It  is  necessary  to  guard  against 
the  corruption  of  food  and  drink  within  the  stom- 
ach; therefore,  easily  corruptible  food — milk,  salt 
fish,  etc. — must  not  be  partaken  of,  and  after  meals 
all  excessive  movement,  running  exercises,  bathing, 
coitus,  and  other  causes  that  impair  the  digestion, 
must  also  be  avoided.  (2)  Everything  must  be 
avoided  that  may  provoke  vomiting.  (3)  Sweet  and 
viscous  food — such  as  dried  figs,  preserves  made 
with  honey,  etc. — must  not  be  partaken  of .  (4)  Hard 
things  must  not  be  broken  with  the  teeth.  (5)  All 
food,  drink,  and  other  substances  that  set  the  teeth 
on  edge  must  be  avoided.  (6)  Food  that  is  too  hot 
or  too  cold  must  be  avoided,  and  especially  the  rapid 
succession  of  hot  and  cold,  and  vice  versa.  (7)  Leeks 
must  not  be  eaten,  as  such  a  food,  by  its  own  nature, 
is  injurious  to  the  teeth.  (8)  The  teeth  must  be 
cleaned  at  once,  after  every  meal,  from  the  particles 
of  food  left  in  them ;  and  for  this  purpose  thin  pieces 
of  wood  should  be  used,  somewhat  broad  at  the  ends, 
but  not  sharp-pointed  or  edged;  and  preference 
should  be  given  to  small  cypress  twigs,  to  the 
wood  of  aloes,  or  pine,  rosemary,  or  juniper  and 
similar  sorts  of  wood  which  are  rather  bitter  and 
styptic;  care  must,  however,  be  taken  not  to  search 
too  long  in  the  dental  interstices  and  not  to  injure  the 
gums  or  shake  the  teeth.  (9)  After  this  it  is  neces- 
sary to  rinse  the  mouth  by  using  by  preference  a 
vinous  decoction  of  sage,  or  one  of  cinnamon, 
mastich,  gallia,  moschata,  cubeb,  juniper  seeds,  root 
of  cyperus,  and  rosemary  leaves.  (10)  The  teeth 
must  be  rubbed  with  suitable  dentrifices  before  going 
to  bed,  or  else  in  the  morning  before  breakfast.  Al- 
though Avicenna  recommended  various  oils  for  this 


326  OLD-TIME  MAKERS  OF  MEDICINE 

purpose,  Giovanni  of  Arcoli  appears  very  hostile  to 
oleaginous  frictions,  because  lie  considers  them  very 
injurious  to  the  stomach.  He  observes,  besides,  that 
whilst  moderate  frictions  of  brief  duration  are  help- 
ful to  the  teeth,  strengthen  the  gums,  prevent  the 
formation  of  tartar,  and  sweeten  the  breath,  too 
rough  or  too  prolonged  rubbing  is,  on  the  contrary, 
harmful  to  the  teeth,  and  makes  them  liable  to  many 
diseases." 

All  this  is  so  modern  in  many  ways  that  we  might 
expect  a  detailed  exact  knowledge  of  the  anatomy 
of  the  teeth  and  even  something  of  their  embryology 
from  Arculanus.  It  must  not  be  forgotten,  however, 
that  coming  as  he  does  before  the  Renaissance,  the 
medical  sciences  in  the  true  sense  of  the  word  are 
as  yet  unborn.  Men  are  accumulating  information 
for  practical  purposes  but  not  for  the  classification 
and  co-ordination  that  was  to  make  possible  the 
scientific  development  of  their  knowledge. 

Giovanni  of  Arcoli 's  acquaintance  with  the  anat- 
omy of  the  teeth  was  rather  sadly  lacking.  He  does 
not  know  even  with  certainty  the  number  of  roots 
that  the  teeth  have.  This  has  been  attributed  to 
the  fact  that  he  obtained  most  of  his  information 
from  books,  and  had  not  the  time  to  verify  de- 
scriptions that  he  had  found.  It  has  been  argued 
from  this  that  he  was  himself  probably  not  a  prac- 
tical dentist,  and  turned  to  that  specialty  only  as  a 
portion  of  his  work  as  a  general  surgeon,  and  that 
consequently  he  was  not  sufficiently  interested  to 
verify  his  statements.  His  chapters  on  dentistry 
would  seem  to  bear  out  this  conclusion  to  some  ex- 
tent, though  the  very  fact  that  one  who  was  himself 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ARCOLI     327 

not  specially  interested  in  dental  surgery  should 
have  succeeded  in  gathering  together  so  much  that 
anticipates  modern  ideas  in  dentistry,  is  of  itself  a 
proof  of  how  much  knowledge  of  the  subject  there 
was  available  for  a  serious  student  of  that  time. 
The  anatomy  of  the  teeth  continued  to  be  rather 
vague  until  about  the  middle  of  the  next  century 
when  Eustachius,  whose  investigations  of  the  anat- 
omy of  the  head  have  deservedly  brought  him  fame 
and  the  attachment  of  his  name  to  the  Eustachian 
canal,  wrote  his  "  Libellus  de  Dentibus — Manual  of 
the  Teeth,"  which  is  quite  full,  accurate,  and  de- 
tailed. Very  little  has  been  added  to  the  microscopic 
anatomy  of  the  teeth  since  Eustachius'  time.  He 
had  the  advantage,  of  course,  of  being  intimately 
in  contact  with  the  great  group  of  Renaissance  anato- 
mists,— Vesalius,  Columbus,  Varolius,  Fallopius,  and 
the  others,  the  great  fathers  of  anatomy.  Besides, 
his  position  as  Papal  Physician  and  Professor  of 
Anatomy  at  the  Papal  Medical  School  at  Rome  gave 
him  opportunities  for  original  investigation,  such  as 
were  not  easily  obtained  elsewhere. 

Arculanus  can  scarcely  be  blamed,  therefore,  for 
not  having  anticipated  the  Renaissance,  and  we  must 
take  him  as  merely  the  culmination  of  medieval 
knowledge  with  regard  to  anatomy  and  surgery. 
Medieval  medical  men  did  not  have  the  time  nor 
apparently  the  incentive  to  make  formal  medical 
science,  though  it  must  not  be  forgotten,  as  has  been 
said,  that  they  did  use  the  knowledge  they  obtained 
by  their  own  and  others '  observation  to  excellent 
advantage  for  the  practical  benefit  of  ailing  hu- 
manity.    The  sciences  related  to  medicine  are  con- 


328  OLD-TIME  MAKERS  OF  MEDICINE 

scious  developments  that  follow  the  evolution  of 
practical  medicine,  nor  must  it  be  forgotten  that 
far  from  always  serving  as  an  auxiliary  to  applied 
medical  science,  often  indeed  in  the  history  of  medi- 
cine scientific  pursuits  have  led  men  away  into  side 
issues  from  which  they  had  to  be  brought  back  by 
some  genius  medical  observer.  As  might  be  ex- 
pected, then,  it  is  with  regard  to  the  practical  treat- 
ment and  general  consideration  of  ailments  of  the 
teeth  that  Giovanni  of  Arcoli  is  most  interesting. 
In  this  some  of  his  chapters  contain  a  marvellous 
series  of  surprises. 

Arculanus  was  probably  born  towards  the  end  of 
the  fourteenth  century.  The  date  of  his  death  is 
variously  placed  as  either  1460  or  1484,  with  the 
probability  in  favor  of  the  former.  From  1412  to 
1427  he  was  professor  at  Bologna,  where  in  accord- 
ance with  the  non-specializing  tendencies  of  the  time 
he  did  not  occupy  a  single  chair  but  several  in  suc- 
cession. He  seems  first  to  have  taught  Logic,  then 
Moral  Philosophy,  and  finally  Medicine.  His  repu- 
tation in  medicine  drew  many  students  to  the  uni- 
versity, and  his  fame  spread  all  over  Italy.  The 
rival  University  of  Padua  then  secured  him,  and 
he  seems  to  have  been  for  some  twenty  years  there. 
Later  apparently  he  accepted  a  professor's  chair 
at  Ferrara,  where  the  D'Estes  were  trying  to  bring 
their  university  into  prominence.  It  was  at  Fer- 
rara that  he  died.  He  was  a  man  of  wide  reading, 
of  extensive  experience,  both  of  men  and  medicine, 
and  one  of  the  scholars  of  his  time.  His  works  are, 
as  we  have  said,  mainly  excerpts  from  earlier  writers 
and  particularly  the  Arabians,  but  they   contain 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  AECOLI     329 

enough  of  hints  drawn  from  his  own  observation  and 
experience  to  make  his  work  of  great  value. 

While,  as  Gurlt  remarks  in  his  "  History  of  Sur- 
gery,' '  Arculanus'  name  is  one  of  those  scarcely 
known — he  is  usually  considered  just  one  of  many 
obscure  writers  of  the  end  of  the  Middle  Ages — his 
writings  deserve  a  better  fate.  They  contain  much 
that  is  interesting  and  a  great  deal  that  must  have 
been  of  the  highest  practical  value  to  his  contempo- 
raries. They  attracted  wide  attention  in  his  own 
and  immediately  succeeding  generations.  The  proof 
of  this  is  that  they  exist  in  a  large  number  of  manu- 
script copies.  Just  as  soon  as  printing  was  intro- 
duced his  books  appeared  in  edition  after  edition. 
His  "  Practica  "  was  printed  in  no  less  than  seven 
editions  in  Venice.  Three  of  them  appeared  before 
the  end  of  the  fifteenth  century,  which  places  them 
among  the  incunabula  of  printing. 

Probably  nothing  in  the  history  of  human  intel- 
lectual interest  is  more  striking  than  the  excellent 
judgment  displayed  by  the  editors  who  selected  the 
works  to  be  printed  at  this  time.  Very  few  of  them 
were  trivial  or  insignificant.  Fewer  still  were  idle 
speculations,  and  most  of  them  were  almost  of  clas- 
sical import  for  literature  and  science.  Four  edi- 
tions of  this  work  were  printed  in  Venice  in  the 
sixteenth  century,  one  of  them  as  late  as  1560,  when 
the  work  done  by  such  men  as  Vesalius,  Columbus, 
Eustachius,  and  Fallopius  would  seem  to  have  made 
Arculanus  out  of  date.  The  dates  of  the  various 
editions  are  Venice,  1483, 1493, 1497, 1504, 1542, 1557, 
and  1560.  Besides  there  was  an  edition  printed  at 
Basel  in  1540. 


330  OLD-TIME  MAKERS  OF  MEDICINE 

Arculanus  is  said  to  have  re-introduced  the  use  of 
the  seton,  that  is  the  method  of  producing  intense 
counter-irritation  by  the  introduction  of  some  foreign 
body  into  an  incision  in  the  skin.  We  owe  to  him, 
too,  according  to  Pagel  in  the  chapters  on  medieval 
medicine  in  Puschmann's  "  Handbook  of  the  History 
of  Medicine,' '  an  excellent  description  of  alcoholic 
insanity. 

His  directions  for  the  treatment  of  conditions  in 
the  mouth  and  nose  apart  from  the  teeth  are  quite 
as  explicit  and  practical,  and  in  many  ways  quite 
as  great  an  anticipation  of  some  of  our  modern  no- 
tions as  what  he  has  to  say  with  regard  to  the  teeth. 
For  instance,  in  the  treatment  of  polyps  he  says  that 
they  should  be  incised  and  cauterized.  Soft  polyps 
should  be  drawn  out  with  a  toothed  tenaculum  as 
far  as  can  be  without  risk  of  breaking  them  off. 
The  incision  should  be  made  at  the  root  so  that 
nothing  or  just  as  little  as  possible  of  the  pathologi- 
cal structure  be  allowed  to  remain.  It  should  be 
cut  off  with  a  fine  scissors,  or  with  a  narrow  file 
just  small  enough  to  permit  its  ingress  into  the 
nostrils,  or  with  a  scalpel  without  cutting  edges  on 
the  sides,  but  only  at  its  extremity,  and  this  cutting 
edge  should  be  broad  and  well  sharpened.  If  there 
is  danger  of  hemorrhage,  or  if  there  is  fear  of  it, 
the  instruments  with  which  dissection  is  made  should 
be  fired  (igniantur),  that  is,  heated  at  least  to  a  dull 
redness.  Afterwards  the  stump,  if  any  remains, 
should  be  touched  with  a  hot  iron  or  else  with 
cauterizing  agents  so  that  as  far  as  possible  it  should 
be  obliterated. 

After  the  operation  a  pledget  of  cotton  dipped  in 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ARCOLI     331 

the  green  ointment  described  by  Khazes  should  be 
placed  in  the  nose.  This  pledget  should  have  a 
string  fastened  to  it,  hanging  from  the  nose  in  order 
that  it  may  be  easily  removed.  At  times  it  may  be 
necessary  to  touch  the  root  of  the  polyp  with  a  stylet 
on  which  cotton  has  been  placed  that  has  been  dipped 
in  aqua  fortis  (nitric  acid).  It  is  important  that 
this  cauterizing  fluid  should  be  rather  strong  so  that 
after  a  certain  number  of  touches  a  rather  firm 
eschar  is  produced.  In  all  these  manipulations  in 
the  nose  Arculanus  recommends  that  the  nose  should 
be  held  well  open  by  means  of  a  nasal  speculum. 
Pictures  of  all  these  instruments  occur  in  his  extant 
works,  and  indeed  this  constitutes  one  of  their  most 
interesting  and  valuable  features.  They  are  to  be 
seen  in  Gurlt's  "  History  of  Surgery." 

In  some  cases  he  had  seen  the  polyp  was  so 
difficult  to  get  at  or  was  situated  so  far  back  in 
the  nose  that  it  could  not  be  reached  by  means  of  a 
tenaculum  or  scissors,  or  even  the  special  knife  de- 
vised for  that  purpose.  For  these  patients  Arcu- 
lanus describes  an  operation  that  is  to  be  found  in 
the  older  writers  on  surgery,  Paul  of  iE'gina  (iEgi- 
netus),  Avicenna,  and  some  of  the  other  Arabian 
surgeons.  For  this  three  horse-tail  hairs  are  twisted 
together  and  knotted  in  three  or  four  places,  and  one 
end  is  passed  through  the  nostrils  and  out  through 
the  mouth.  The  ends  of  this  are  then  pulled  on 
backward  and  forward  after  the  fashion  of  a  saw. 
Arculanus  remarks  evidently  with  the  air  of  a  man 
who  has  tried  it  and  not  been  satisfied  that  this 
operation  is  quite  uncertain,  and  seems  to  depend 
a  great  deal  on  chance,  and  much  reliance  must  not 


332  OLD-TIME  MAKEES  OF  MEDICINE 

be  placed  on  it.  Arculanus  suggests  a  substitute 
method  by  which  latent  polyps  or  occult  polyps  as 
he  calls  them  may  be  removed. 

There  is  scarcely  an  important  disease  for  which 
Arculanus  has  not  some  interesting  suggestions,  and 
the  more  one  reads  of  him  the  more  is  one  surprised 
to  find  how  many  things  that  we  might  think  of  as 
coming  into  the  purview  of  medicine  long  after  his 
time  or  at  least  as  having  been  neglected  from  the 
time  of  the  Greeks  almost  down  to  our  own  time 
are  here  treated  explicitly,  definitely,  and  with  ex- 
cellent practical  suggestions.  He  has  a  good  deal 
to  say  with  regard  to  the  treatment  of  angina,  which 
he  calls  synanche,  or  synanchia,  or  cynanche,  or  an- 
gina. Parasynanche  is  a  synonymous  term,  but 
refers  to  a  milder  synanche.  He  distinguished  four 
forms  of  it.  In  one  called  canine  angina,  because 
the  patient's  tongue  hangs  out  of  his  mouth,  some- 
what the  same  as  from  an  overheated  dog  in  the 
summer  time,  while  at  the  same  time  the  mouth  is 
held  open  and  he  draws  his  breath  pantingly,  Arcu- 
lanus suggests  an  unfavorable  prognosis,  and  would 
seem  to  refer  to  those  cases  of  Ludwig's  angina  in 
which  there  is  involvement  of  the  tongue  and  in  which 
our  prognosis  continues  to  be  of  the  very  worst 
even  to  our  own  day.  At  times  the  angina  causes 
such  swelling  in  the  throat  that  the  breathing  is 
interfered  with  completely.  For  this  Arculanus* 
master,  Rhazes,  advised  tracheotomy.  Arculanus 
himself,  however,  apparently  hesitated  about  that. 

It  is  not  surprising,  then,  to  find  that  Arculanus 
is  very  explicit  in  his  treatment  of  affections  of  the 
uvula.    He   divides   its   affections   into    apostema, 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ABCOLI     333 

ulcus,  putredo  sive  corrosio,  et  casus.  Apostema 
was  abscess,  ulcus  any  rather  deep  erosion,  putredo 
a  gangrenous  condition,  and  casus  the  fall  of  the 
uvula.  This  is  the  notorious  falling  of  the  soft 
palate  which  has  always  been  in  popular  medical 
literature  at  least.  Arculanus  describes  it  as  a  pre- 
ternatural elongation  of  the  uvula  which  sometimes 
goes  to  such  an  extent  as  to  make  it  resemble  the 
tail  of  a  mouse.  For  shorter  elongations  he  sug- 
gests the  cautery;  for  longer,  excision  followed  by 
the  cautery  so  that  the  greater  portion  of  the  ex- 
tending part  may  be  cut  off.  If  people  fear  the 
knife  he  suggests  following  Ehazes,  the  application 
of  an  astringent  powder  directly  to  the  part  by 
blowing  through  a  tube.  His  directions  for  the 
removal  of  the  uvula  are  very  definite.  Seat  the 
patient  upon  a  stool  in  a  bright  light  while  an 
assistant  holds  the  head;  after  the  tongue  has  been 
firmly  depressed  by  means  of  a  speculum  let  the 
assistant  hold  this  speculum  in  place.  With  the  left 
hand  then  insert  an  instrument,  a  stilus,  by  which  the 
uvula  is  pulled  forward,  and  then  remove  the  end 
of  it  by  means  of  a  heated  knife  or  some  other 
process  of  cauterization.  The  mouth  should  after- 
wards be  washed  out  with  fresh  milk. 

The  application  of  a  cauterizing  solution  by  means 
of  a  cotton  swab  wrapped  round  the  end  of  a  sound 
may  be  of  service  in  patients  who  refuse  the  actual 
cautery.  To  be  successful  the  application  must  be 
firmly  made  and  must  be  frequently  repeated. 

After  this  it  is  not  surprising  to  find  that  Arcu- 
lanus has  very  practical  chapters  on  all  the  other 
ordinary  surgical  affections.    Empyema  is  treated 


334  OLD-TIME  MAKEBS  OF  MEDICINE 

very  thoroughly,  liver  abscess,  ascites,  which  he 
warns  must  be  emptied  slowly,  ileus  especially  when 
it  reaches  stercoraceous  vomiting,  and  the  various 
difficulties  of  urination,  he  divides  them  into  dysuria, 
ischuria,  and  stranguria,  are  all  discussed  in  quite 
modern  fashion.  He  gives  seven  causes  for  diffi- 
culty of  urination.  One,  some  injury  of  the  bladder ; 
two,  some  lesion  of  the  urethra ;  three,  some  patho- 
logical condition  in  the  power  to  make  the  bladder 
contract;  four,  some  injury  of  the  muscle  of  the 
neck  of  the  bladder ;  five,  some  pathological  condition 
of  the  urine;  six,  some  kidney  trouble,  and  seven, 
some  pathological  condition  of  the  general  system. 
He  takes  up  each  one  of  these  and  discusses  the  vari- 
ous phases,  causes,  disposition,  and  predispositions 
that  bring  them  about.  One  thing  these  men  of  the 
Middle  Ages  could  do,  they  reasoned  logically,  they 
ordered  what  they  had  to  say  well,  and  they  wrote  it 
out'  straightforwardly. 

That  Arcuianus'  work  with  regard  to  dentistry 
was  no  mere  chance  and  not  solely  theoretic  can 
be  understood  very  well  from  his  predecessors,  and 
that  it  formed  a  link  in  a  continuous  tradition  which 
was  well  preserved  we  may  judge  from  what  is  to 
be  found  in  the  writings  of  his  great  successor, 
Giovanni  or  John  de  Vigo,  who  is  considered  one 
of  the  great  surgeons  of  the  early  Eenaissance,  and 
to  whom  we  owe  what  is  probably  the  earliest  treatise 
on  ' '  Gun-shot  "Wounds. ' '  John  of  Vigo  was  a  Papal 
physician  and  surgeon,  generally  considered  one  of 
the  most  distinguished  members  of  the  medical  pro- 
fession of  his  time.  Two  features  of  his  writing  on 
dental  diseases  deserve  mention.    He  insists  that 


MEDIEVAL  DENTISTRY— GIOVANNI  OF  ABCOLI     335 

abscesses  of  the  gums  shall  be  treated  as  other  ab- 
scesses by  being  encouraged  to  come  to  maturity  and 
then  being  opened.  If  they  do  not  close  promptly, 
an  irritant  Egyptian  ointment  containing  verdigris 
and  alum  among  other  things  should  be  applied  to 
them.  In  the  cure  of  old  fistulous  tracts  near  the 
teeth  he  employs  not  only  this  Egyptian  ointment 
but  also  arsenic  and  corrosive  sublimate.  What  he 
has  to  say  with  regard  to  the  filling  of  the  teeth  is, 
however,  most  important.  He  says  it  with  extreme 
brevity,  but  with  the  manner  of  a  man  thoroughly 
accustomed  to  doing  it.  "  By  means  of  a  drill  or 
file  the  putrefied  or  corroded  part  of  the  tooth  should 
be  completely  removed.  The  cavity  left  should  then 
be  filled  with  gold  leaf."  It  is  evident  that  the 
members  of  the  Papal  court,  the  Cardinals  and  the 
Pope  himself,  had  the  advantage  of  rather  good  den- 
tistry at  John  de  Vigo's  hands  even  as  early  as  the 
beginning  of  the  sixteenth  century. 

John  de  Vigo,  however,  is  not  medieval.  He  lived 
on  into  the  sixteenth  century  and  was  influenced 
deeply  by  the  Renaissance.  He  counts  among  the 
makers  of  modern  medicine  and  surgery,  as  his 
authorship  of  the  treatise  on  gun-shot  wounds  makes 
clear.  He  comes  in  a  period  that  will  be  treated  of 
in  a  later  volume  of  this  series  on  ' '  Our  Forefathers 
in  Medicine. ' ' 


XIII 

CUSANUS  AND  THE  FIRST  SUGGESTION  OF 
LABORATORY  METHODS  IN  MEDICINE 

As  illustrating  how,  as  we  know  more  about 
the  details  of  medical  history,  the  beginnings  of 
medical  science  and  medical  practice  are  pushed 
back  farther  and  farther,  a  discussion  in  the  Ber- 
liner klinische  Wochenschrift  a  dozen  years  ago  is 
of  interest.  Professor  Ernest  von  Leyden,  in  sketch- 
ing the  history  of  the  taking  of  the  pulse  as  an  impor- 
tant aid  in  diagnostics,  said  that  John  Floyer  was 
usually  referred  to  as  the  man  who  introduced  the 
practice  of  determining  the  pulse  rate  by  means  of 
the  watch.  His  work  was  done  about  the  beginning  of 
the  eighteenth  century.  Professor  von  Leyden  sug- 
gested, however,  that  "William  Harvey,  the  English 
physiologist,  to  whom  is  usually  attributed  the  dis- 
covery of  the  circulation  of  the  blood,  had  empha- 
sized the  value  of  the  pulse  in  medical  diagnosis, 
and  also  suggested  the  use  of  the  watch  in  counting 
the  pulse.  Professor  Carl  Binz,  of  the  University  of 
Bonn,  commenting  on  these  remarks  of  Professor 
von  Leyden,  called  attention  to  the  fact  that  more 
than  a  century  before  the  birth  of  either  of  these  men, 
even  the  earlier,  to  whom  the  careful  measurement 
of  the  pulse  rate  is  thus  attributed  as  a  discovery, 
a  distinguished  German  churchman,  who  died 
shortly  after  the  middle  of  the  fifteenth  century,  had 

336 


FIEST  SUGGESTION  OF  LABORATORY  METHODS     337 

suggested  a  method  of  accurate  estimation  of  the 
pulse  that  deserves  a  place  in  medical  history. 

This  suggestion  is  so  much  in  accord  with  modern 
demands  for  greater  accuracy  in  diagnosis  that  it 
seems  not  inappropriate  to  talk  of  it  as  the  first 
definite  attempt  at  laboratory  methods  in  the  de- 
partment of  medicine.  The  maker  of  the  sugges- 
tion, curiously  enough,  was  not  a  practising  physi- 
cian, but  a  mathematician  and  scholar,  Cardinal 
Nicholas  of  Cusa,  who  is  known  in  history  as 
Cusanus  from  the  Latin  name  of  the  town  Cues  on 
the  Moselle  River,  some  twenty-five  miles  south  of 
Treves,  where  he  was  born.  His  family  name, 
Nicholas  Krebs,  has  been  entirely  lost  sight  of  in 
the  name  derived  from  his  native  town,  which  is  the 
only  reason  why  most  of  the  world  knows  anything 
about  that  town.  Cardinal  Cusanus  suggested  that 
in  various  forms  of  disease  and  at  various  times  of 
life,  as  in  childhood,  boyhood,  manhood,  and  old 
age,  the  pulse  was  very  different.  It  would  be  ex- 
tremely valuable  to  have  some  method  of  accurately 
estimating,  measuring,  and  recording  these  differ- 
ences for  medical  purposes.  At  that  time  watches 
had  not  yet  been  invented,  and  it  would  have  been 
very  difficult  to  have  estimated  the  time  by  the 
clocks,  for  almost  the  only  clocks  in  existence  were 
those  in  the  towers  of  the  cathedrals  and  of  the  pub- 
lic buildings.  The  first  watches,  Nuremberg  eggs, 
as  they  were  called,  were  not  made  by  Peter  Hen- 
lein  until  well  on  into  the  next  century.  The  only 
method  of  measuring  time  with  any  accuracy  in 
private  houses  was  the  clepsydra  or  water-clock, 
which  measured  the  time  intervals  by  the  flow  of  a 


338  OLD-TIME  MAKERS  OF  MEDICINE 

definite  amount  of  water.  Cardinal  Cusanus  sug- 
gested then  that  the  water-clock  should  be  employed 
for  estimating  the  pulse  frequency.  His  idea  was 
that  the  amount  of  water  which  flowed  while  a  hun- 
dred beats  of  the  pulse  were  counted,  should  be 
weighed,  and  this  weight  compared  with  that  of 
the  average  weight  of  water  which  flowed  while  a 
hundred  beats  of  the  normal  pulse  of  a  number  of 
individuals  of  the  same  age  and  constitution  were 
being  counted. 

This  was  a  very  simple  and  a  very  ingenious  sug- 
gestion. We  have  no  means  of  knowing  now 
whether  it  was  adopted  to  any  extent  or  not.  It 
may  seem  rather  surprising  that  a  cardinal  should 
have  been  the  one  to  make  such  a  suggestion. 
Cusanus,  however,  was  very  much  interested  in 
mathematics  and  in  the  natural  sciences,  and  we 
have  many  wonderful  suggestions  from  his  pen. 
He  was  the  first,  for  instance,  to  suggest,  more  than 
a  century  before  Copernicus,  that  the  earth  was  not 
the  centre  of  the  universe,  and  that  it  would  not  be 
absolutely  at  rest  or,  as  he  said,  devoid  of  all  mo- 
tion. His  words  are:  "  Terra  igitur,  qiue  centrum 
esse  nequit,  motu  omni  car  ere  non  potest."  He  de- 
scribed very  clearly  how  the  earth  moved  round  its 
own  axis,  and  then  he  added,  what  cannot  fail  to  be  a 
surprising  declaration  for  those  in  the  modern  times 
who  think  such  an  idea  of  much  later  origin,  that  he 
considered  that  the  earth  itself  cannot  be  fixed,  but 
moves  as  do  the  other  stars  in  the  heavens.  The 
expression  is  so  astonishing  at  that  time  in  the 
world's  history  that  it  seems  worth  the  while  to 
give  it  in  its  original  form,  so  that  it  may  be  seen 


FIRST  SUGGESTION  OF  LABORATORY  METHODS     339 

clearly  that  it  is  not  any  subsequent  far-fetched  in- 
terpretation of  his  opinion,  but  the  actual  words 
themselves,  that  convey  this  idea.  He  said:  "  Con- 
sideravi  quod  terra  ista  non  potest  esse  fixa,  sed 
movetur  ut  alice  stellce." 

How  clearly  Cusanus  anticipated  another  phase 
of  our  modern  views  may  be  judged  from  what  he 
has  to  say  in  "  De  Docta  Ignorantia  ' '  with  regard  to 
the  constitution  of  the  sun.  It  is  all  the  more  sur- 
prising that  he  should  by  some  form  of  intuition 
reach  such  a  conclusion,  for  the  ordinary  sources  of 
information  with  regard  to  the  sun  would  not  sug- 
gest such  an  expression  except  to  a  genius,  whose 
intuition  outran  by  far  the  knowledge  of  his  time. 
The  Cardinal  said:  "  To  a  spectator  on  the  surface 
of  the  sun  the  splendor  which  appears  to  us  would 
be  invisible,  since  it  contains,  as  it  were,  an  earth 
for  its  central  mass,  with  a  circumferential  envelope 
of  light  and  heat,  and  between  the  two  an  atmos- 
phere of  water  and  clouds  and  of  ambient  air." 
After  reading  that  bit  of  precious  astronomical  sci- 
ence announced  nearly  five  centuries  ago,  it  is  easy 
to  understand  how  Copernicus  could  have  an- 
ticipated other  phases  of  our  knowledge,  as  he  did 
in  his  declarations  that  the  figure  of  the  earth  is 
not  a  sphere,  but  is  somewhat  irregular,  and  that 
the  orbit  of  the  earth  is  not  circular. 

Cusanus  was  an  extremely  practical  man,  and  was 
constantly  looking  for  and  devising  methods  of  ap- 
plying practical  principles  of  science  to  ordinary 
life.  As  we  shall  see  in  discussing  his  suggestion 
for  the  estimation  of  the  pulse  rate  later  on,  he 
made  many  other  similar  suggestions  for  diagnostic 


340  OLD-TIME  MAKERS  OF  MEDICINE 

purposes  in  medicine,  and  set  forth  other  applica- 
tions of  mathematics  and  mechanics  to  his  genera- 
tion. 

Many  of  Cusanus'  books  have  curiously  modern 
names.  He  wrote,  for  instance,  a  series  of  mathe- 
matical treatises,  in  Latin  of  course,  on  *  *  Geometric 
Transmutations,' '  on  "  Arithmetical  Comple- 
ments/ '  on  "  Mathematical  Complements,' '  on 
"  Mathematical  Perfection,"  and  on  "  The  Correc- 
tion of  the  Calendar. ' '  In  his  time  the  calendar  was 
in  error  by  more  than  nine  days,  and  Cusanus  was 
one  of  those  who  aroused  sufficient  interest  in  the 
subject,  so  that  in  the  next  century  the  correction 
was  actually  made  by  the  great  Jesuit  mathemati- 
cian, Father  Clavius.  Perhaps  the  work  of  Cusanus 
that  is  best  known  is  that ' '  On  Learned  Ignorance — 
De  Docta  Ignorantia, ' '  in  which  the  Cardinal  points 
out  how  many  things  that  educated  people  think  they 
know  are  entirely  wrong.  It  reminds  one  very  much 
of  Josh  Billings's  remark  that  it  is  not  so  much  the 
ignorance  of  mankind  that  makes  them  ridiculous, 
as  the  knowing  so  many  things  that  ain't  so.  It  is 
from  this  work  that  the  astronomical  quotations 
which  we  have  made  are  taken.  The  book  that  is  of 
special  interest  to  physicians  is  his  dialogue  "  On 
Static  Experiments,"  which  he  wrote  in  1450,  and 
which  contains  the  following  passages : 

"  Since  the  weight  of  the  blood  and  the  urine  of 
a  healthy  and  of  a  diseased  man,  of  a  young  man 
and  an  old  man,  of  a  German  and  an  African,  is 
different  for  each  individual,  why  would  it  not  be 
a  great  benefit  to  the  physician  to  have  all  of  these 
various  differences  classified?     For  I  think  that  a 


FIRST  SUGGESTION  OF  LABORATORY  METHODS     341 

physician  would  make  a  truer  judgment  from  the 
weight  of  the  urine  viewed  in  connection  with  its 
color  than  he  could  make  from  its  color  alone,  which 
might  be  fallacious.  So,  also,  weight  might  be  used 
as  a  means  of  identifying  the  roots,  the  stems,  the 
leaves,  the  fruits,  the  seeds,  and  the  juice  of  plants 
if  the  various  weights  of  all  the  plants  were  properly 
noted,  together  with  their  variety,  according  to  lo- 
cality. In  this  way  the  physician  would  appreciate 
their  nature  better  by  means  of  their  weight  than 
if  he  judged  them  by  their  taste  alone.  He  might 
know,  then,  from  a  comparison  of  the  weights  of 
the  plants  and  their  various  parts  when  compared 
with  the  weight  of  the  blood  and  the  urine,  how  to 
make  an  application  and  a  dosage  of  drugs  from  the 
concordances  and  differences  of  the  medicaments, 
and  even  might  be  able  to  make  an  excellent  prog- 
nosis in  the  same  way.  Thus,  from  static  experi- 
ments, he  would  approach  by  a  more  precise  knowl- 
edge to  every  kind  of  information. 

1 '  Do  you  not  think  if  you  would  permit  the  water 
from  the  narrow  opening  of  a  clepsydra  [water- 
clock]  to  flow  into  a  basin  for  as  long  as  was  neces- 
sary to  count  the  pulse  a  hundred  times  in  a  healthy 
young  man,  and  then  do  the  same  thing  for  an  ail- 
ing young  man,  that  there  would  be  a  noticeable  dif- 
ference between  the  weights  of  the  water  that  would 
flow  during  the  period?  From  the  weight  of  the 
water,  therefore,  one  would  arrive  at  a  better  knowl- 
edge of  the  differences  in  the  pulse  of  the  young  and 
the  old,  the  healthy  and  the  unhealthy,  and  so,  also, 
as  to  information  with  regard  to  various  diseases, 
since  there  would  be  one  weight  and,  therefore,  one 
pulse  in  one  disease,  and  another  weight  and  another 
pulse  in  another  disease.  In  this  way  a  better  judg- 
ment of  the  differences  in  the  pulse  could  be  ob- 
tained than  from  the  touch  of  the  vein,  just  as  more 
can  be  known  from  the  urine  about  its  weight  than 
from  its  color  alone. 


342  OLD-TIME  MAKERS  OF  MEDICINE 

"  Just  in  the  same  way  would  it  not  be  possible 
to  make  a  more  accurate  judgment  with  regard  to 
the  breathing,  if  the  inspirations  and  expirations 
were  studied  according  to  the  weight  of  the  water 
that  passed  during  a  certain  interval?  If,  while 
water  was  flowing  from  a  clepsydra,  one  were  to 
count  a  hundred  expirations  in  a  boy,  and  then  in 
an  old  man,  of  course,  there  would  not  be  the  same 
amount  of  water  at  the  end  of  the  enumeration. 
Then  this  same  thing  might  be  done  for  other  ages 
and  states  of  the  body.  As  a  consequence,  when 
the  physician  once  knew  what  the  weight  of  water 
that  represented  the  number  of  expirations  of  a 
healthy  boy  or  youth,  and  then  of  an  individual  of 
the  same  age  ill  of  some  infirmity  or  other,  there  is 
no  doubt  that,  by  this  observation,  he  will  come  to 
a  knowledge  of  the  health  or  illness  and  something 
about  the  case,  and,  perhaps,  also  with  more  cer- 
tainty would  be  able  to  choose  the  remedy  and  the 
dose  required.  If  he  found  in  a  healthy  young 
man  apparently  the  same  weight  as  in  an  old  and 
decrepit  individual,  he  might  readily  be  brought  to 
the  conclusion  that  the  young  man  would  surely  die, 
and  in  this  way  have  some  evidence  for  his  prog- 
nosis in  the  case.  Besides,  if  in  fevers,  in  the  same 
way,  careful  studies  were  made  of  the  differences 
in  the  weight  of  water  for  pulse  and  respiration  in 
the  warm  and  the  cold  paroxysms,  would  it  not  be 
possible  thus  to  know  the  disease  better  and,  per- 
haps, also  get  a  more  efficacious  remedy?  " 

As  will  be  seen  from  this  passage,  Cusanus  had 
many  more  ideas  than  merely  the  accurate  estima- 
tion of  the  pulse  frequency  when  he  suggested  the 
use  of  the  water-clock.  Evidently  the  thought  had 
come  to  him  that  the  specific  gravity  of  the  sub- 
stances, that  is,  their  weight  in  comparison  to  the 
weight  of  water,  might  be  valuable  information. 


FIRST  SUGGESTION  OF  LABORATORY  METHODS     343 

Before  his  time,  physicians  had  depended  only  on 
the  color  and  the  taste  of  the  urine  for  diagnostic 
purposes.  He  proposed  that  4:hey  should  weigh  it, 
and  even  suggested  that  they  should  weigh,  also,  the 
blood,  I  suppose  in  case  of  venesection,  for  com- 
parison's sake.  He  also  thought  that  the  compara- 
tive weight  of  various  roots,  stems,  leaves,  juices  of 
plants  might  give  hints  for  the  therapeutic  uses  of 
these  substances.  This  is  the  sort  of  idea  that  we 
are  apt  to  think  of  as  typically  modern.  Specific 
gravities  and  atomic  weights  have  been  more  than 
once  supposed  to  represent  laws  in  therapeutics, 
which  so  far,  however,  we  have  not  succeeded  in 
finding,  but  it  is  interesting  to  realize  that  it  is 
nearly  five  hundred  years  since  the  first  thought  in 
this  line  was  clearly  expressed  by  a  distinguished 
thinker  and  scientific  writer. 

There  are  many  interesting  expressions  in 
CuBanus'  writings  which  contradict  most  of  the  im- 
pressions commonly  entertained  with  regard  to  the 
scholars  of  the  Middle  Ages.  It  is  usually  assumed 
that  they  did  not  think  seriously,  but  speculatively, 
that  they  feared  to  think  for  themselves,  neglected 
the  study  of  nature  around  them,  considered  author- 
ity the  important  source  of  knowledge,  and  were  as 
far  as  possible  from  the  standpoint  of  modern  sci- 
entific students  and  investigators.  Here  is  a 
passage  from  Nicholas,  on  knowing  and  thinking, 
that  might  well  have  been  written  by  a  great  intel- 
lectual man  at  any  time  in  the  world's  history,  and 
that  could  only  emanate  from  a  profound  scholar  at 
any  time. 


344  OLD-TIME  MAKEBS  OF  MEDICINE 

11  To  know  and  to  think,  to  see  the  truth  with  the 
eye  of  the  mind,  is  always  a  joy.  The  older  a  man 
grows  the  greater  is  the  pleasure  which  it  affords 
him,  and  the  more  he  devotes  himself  to  the  search 
after  truth,  the  stronger  grows  his  desire  of  pos- 
sessing it.  As  love  is  the  life  of  the  heart,  so  is  the 
endeavor  after  knowledge  and  truth  the  life  of  the 
mind.  In  the  midst  of  the  movements  of  time,  of 
the  daily  work  of  life,  of  its  perplexities  and  con- 
tradictions, we  should  lift  our  gaze  fearlessly  to 
the  clear  vault  of  heaven,  and  seek  ever  to  obtains 
firmer  grasp  of  and  a  keener  insight  into  the  origin 
of  all  goodness  and  beauty,  the  capacities  of  our 
own  hearts  and  minds,  the  intellectual  fruits  of 
mankind  throughout  the  centuries,  and  the  wondrous 
works  of  nature  around  us;  at  the  same  time  re- 
membering always  that  in  humility  alone  lies  true 
greatness,  and  that  knowledge  and  wisdom  are  alone 
profitable  in  so  far  as  our  lives  are  governed  by 
them. ' ' 

The  career  of  Nicholas  of  Cusa  is  interesting,  be- 
cause it  sums  up  so  many  movements,  and,  above  all, 
educational  currents  in  the  fifteenth  century.  He 
was  born  in  the  first  year  of  the  century,  and  lived 
to  be  sixty-four.  He  was  the  son  of  a  wine  grower, 
and  attracted  the  attention  of  his  teachers  because 
of  his  intellectual  qualities.  In  spite  of  compara- 
tively straitened  circumstances,  then,  he  was  af- 
forded the  best  opportunities  of  the  time  for  educa- 
tion. He  went  first  to  the  school  of  the  Brethren 
of  the  Common  Life  at  Deventer,  the  intellectual 
cradle  of  so  many  of  the  scholars  of  this  century. 
Such  men  as  Erasmus,  Conrad  Mutianus,  Johann 
Sintheim,  Hermann  von  dem  Busche,  whom  Strauss 
calls  "  the  missionary  of  human  wisdom,"  and  the 


FIRST  SUGGESTION  OF  LABORATORY  METHODS     345 

teacher  of  most  of  these,  Alexander  Hegius,  who 
has  been  termed  the  schoolmaster  of  Germany,  with 
Nicholas  of  Cusa  and  Eudolph  Agricola  and  others, 
who  might  readily  be  mentioned,  are  the  fruits  of 
the  teaching  of  these  schools  of  the  Brethren  of  the 
Common  Life,  in  one  of  which  Thomas  a  Kempis, 
the  author  of  "  The  Imitation  of  Christ,' '  was,  for 
seventy  years  out  of  his  long  life  of  ninety,  a  teacher. 
Cusanus  succeeded  so  well  at  school  that  he  was 
later  sent  to  the  University  of  Heidelberg,  and  sub- 
sequently to  Padua,  where  he  took  up  the  study  of 
Eoman  law,  receiving  his  doctorate  at  the  age  of 
twenty-three.  This  series  of  educational  oppor- 
tunities will  be  surprising  only  to  those  who  do  not 
know  educational  realities  at  the  beginning  of  the 
fifteenth  century.  There  has  never  been  a  time 
when  a  serious  seeker  after  knowledge  could  find 
more  inspiration.  On  his  return  to  Germany, 
Father  Krebs  became  canon  of  the  cathedral  in 
Coblenz.  This  gave  him  a  modest  income,  and 
leisure  for  intellectual  work  which  was  eagerly 
employed.  He  was  scarcely  more  than  thirty  when 
he  was  chosen  as  a  delegate  to  the  Council  at  Basel. 
After  this  he  was  made  Archdeacon  of  the  Cathedral 
of  Liittich,  and  from  this  time  his  rise  in  ecclesi- 
astical preferment  was  rapid.  He  had  attracted  so 
much  attention  at  the  Council  of  Basel  that  he  was 
chosen  as  a  legate  of  the  Pope  for  the  bringing  about 
certain  reforms  in  Germany.  Subsequently  he  was 
sent  on  ecclesiastical  missions  to  the  Netherlands, 
and  even  to  Constantinople.  At  the  early  age  of 
forty  he  was  made  a  Cardinal.  After  this  he  was 
always  considered  as  one  of  the  most  important 


346  OLD-TIME  MAKERS  OF  MEDICINE 

consultors  of  the  Papacy  in  all  matters  relating  to 
Germany.  During  the  last  twenty-five  years  of  his 
life  in  all  the  relations  of  the  Holy  See  to  Ger- 
many, appeal  was  constantly  made  to  the  wisdom, 
the  experience,  and  the  thoroughly  conservative, 
yet  foreseeing,  judgment  of  this  son  of  the  people, 
whose  education  had  lifted  him  up  to  be  one  of  the 
leaders  of  men  in  Europe. 

It  was  during  this  time  that  he  wrote  most  of  his 
books  on  mathematics,  which  have  earned  for  him 
a  prominent  place  in  Cantor's  "  History  of  Mathe- 
matics," about  a  score  of  pages  being  devoted  to 
his  work.  Much  of  his  thinking  was  done  while 
riding  on  horseback  or  in  the  rude  vehicles  of  the 
day  on  the  missions  to  which  he  was  sent  as  Papal 
Legate.  He  is  said  to  have  worked  out  the  formula 
for  the  cycloid  curve  while  watching  the  path  de- 
scribed by  flies  that  had  lighted  on  the  wheels  of  his 
carriage,  and  were  carried  forward  and  around  by 
them.  His  scientific  books,  though  they  included 
such  startling  anticipations  of  Copernicus'  doc- 
trines as  we  have  already  quoted  (Copernicus  did 
not  publish  the  first  sketch  of  his  theory  for  more 
than  a  quarter  of  a  century  after  Cusanus'  death), 
far  from  disturbing  his  ecclesiastical  advancement 
or  injuring  his  career  as  a  churchman,  seem  actu- 
ally to  have  been  considered  as  additional  reasons 
for  considering  him  worthy  of  confidence  and  con- 
sultation. 

As  the  result  of  his  careful  studies  of  conditions 
in  Germany,  he  realized  very  clearly  how  much  of 
unfortunate  influence  the  political  status  of  the  Ger- 
man people,  with  their  many  petty  rulers  and  the 


FIRST  SUGGESTION  OF  LAB  0  It  AT  0  BY  METHODS     347 

hampering  of  development  consequent  upon  the 
trivial  rivalries,  the  constant  bickerings,  and  the 
inordinate  jealousies  of  these  numerous  princelings, 
had  upon  his  native  country.  Accordingly,  towards 
the  end  of  his  life  he  sketched  what  he  thought 
would  be  the  ideal  political  status  for  the  German 
people.  As  in  everything  that  he  wrote,  he  went 
straight  to  the  heart  of  the  matter  and,  without 
mincing  words,  stated  just  exactly  what  he  thought 
ought  to  be  done.  Considering  that  this  scheme  of 
Cusanus  for  the  prosperity  and  right  government  of 
the  German  people  was  not  accomplished  until  more 
than  four  centuries  after  his  death,  it  is  interesting, 
indeed,  to  realize  how  this  clergyman  of  the  middle 
of  the  fifteenth  century  should  have  come  to  any 
such  thought.  Nothing,  however,  makes  it  clearer 
than  this,  that  it  is  not  time  that  fosters  thinking, 
but  that  great  men  at  any  time  come  to  great 
thoughts.     Cusanus  wrote : 

' '  The  law  and  the  kingdom  should  be  placed  under 
the  protection  of  a  single  ruler  or  authority.  The 
small  separate  governments  of  princes  and  counts 
consume  a  disproportionately  large  amount  of  rev- 
enue without  furnishing  any  real  security.  For  this 
reason  we  must  have  a  single  government,  and  for 
its  support  we  must  have  a  definite  amount  of  the 
income  from  taxes  and  revenues  yearly  set  aside  by 
a  representative  parliament  and  before  this  parlia- 
ment (reichstag)  must  be  given  every  year  a  definite 
account  of  the  money  that  was  spent  during  the  pre- 
ceding year." 

Cusanus'  life  and  work  stand,  then,  as  a  type  of 
the  accomplishment,  the  opportunities,  the  power  of 
thought,  the  practical  scholarship,  the  mathematical 


348  OLD-TIME  MAKERS  OF  MEDICINE 

accuracy,  the  fine  scientific  foresight  of  a  scholar  of 
the  fifteenth  century.  For  us,  in  medicine,  it  is  in- 
teresting indeed  to  realize  that  it  is  from  a  man  of 
this  kind  that  a  great  new  departure  in  medicine 
with  regard  to  the  employment  of  exact  methods  of 
diagnosis  had  its  first  suggestion  in  modern  times. 
The  origin  of  that  suggestion  is  typical.  It  has 
practically  always  been  true  that  it  was  not  the 
man  who  had  exhausted,  or  thought  that  he  had  done 
so,  all  previous  medical  knowledge,  who  made  ad- 
vances in  medicine  for  us.  It  has  nearly  always 
been  a  young  man  early  in  his  career,  and  at  a  time 
when,  as  yet,  his  mind  was  not  overloaded  with  the 
medical  theories  of  his  own  time.  Cusanus  was 
probably  not  more  than  thirty  when  he  made  the 
suggestion  which  represents  the  first  practical  hint 
for  the  use  of  laboratory  methods  in  modern  medi- 
cine. It  came  out  of  his  thoughtful  consideration  of 
medical  problems  rather  than  from  a  store  of  gar- 
nered information  as  to  what  others  thought.  It  is 
a  lesson  in  the  precious  value  of  breadth  of  educa- 
tion and  serious  training  of  mind  for  real  progress 
at  all  times. 


XIV 

BASIL  VALENTINE,  LAST  OF  THE  ALCHE- 
MISTS, FIRST  OF  THE  CHEMISTS 

"  Fieri  enim  potest  ut  operator  erret  et  a  via 
regia  deflectat,  sed  ut  erret  natura  quando  recte 
tractatur  fieri  non  potest.' ' 

"  For  it  is  quite  possible  that  the  physician  should 
err  and  be  turned  aside  from  the  straight  (royal) 
road,  but  that  nature  when  she  is  rightly  treated 
should  err  is  quite  impossible. ' ' 

This  is  one  of  the  preliminary  maxims  of  a 
treatise  on  medicine  written  by  a  physician  born 
not  later  than  the  first  half  of  the  fifteenth  century, 
and  who  may  have  lived  even  somewhat  earlier.  We 
are  so  prone  to  think  of  the  men  of  that  time  as 
utterly  dependent  on  authority,  not  daring  to  follow 
their  own  observation,  suspecting  nature,  and  al- 
most sure  to  be  convinced  that  only  by  going  counter 
to  her  could  success  in  the  treatment  of  disease  be 
obtained,  that  it  is  a  surprise  to  most  people  to  find 
how  completely  the  attitude  of  mind,  that  is  sup- 
posed to  be  so  typically  modern  in  this  regard,  was 
anticipated  full  four  centuries  ago.  There  are 
other  expressions  of  this  same  great  physician  and 
medical  writer,  Basil  Valentine,  which  serve  to  show 
how  faithfully  he  strove  with  the  lights  that  he  had 
to  work  out  the  treatment  of  patients,  just  as  we  do 
now,  by  trying  to  find  out  nature's  way,  so  as  to 

349 


350  OLD-TI31E  MAKERS  OF  MEDICINE 

imitate  her  beneficent  processes  and  purposes.  It 
is  quite  clear  that  he  is  but  one  of  many  faithful, 
patient  observers  and  experimenters — true  sci- 
entists in  the  best  sense  of  the  word — who  lived  in 
all  the  centuries  of  the  Middle  Ages. 

Speculations  and  experiments  with  regard  to  the 
elixir  of  life,  the  philosopher's  stone,  and  the  trans- 
mutation of  metals,  are  presumed  to  have  filled  up 
all  the  serious  interests  of  the  alchemists,  supposed 
to  be  almost  the  only  scientists  of  those  days.  As 
a  matter  of  fact,  however,  men  were  making  original 
observations  of  profound  significance,  and  these 
were  considered  so  valuable  by  their  contemporaries 
that,  though  printing  had  not  yet  been  invented, 
even  the  immense  labor  involved  in  the  manifold 
copying  of  large  folio  volumes  by  the  slow  hand 
process  did  not  suffice  to  deter  them  from  multiply- 
ing the  writings  of  these  men  so  numerously  that 
they  were  preserved  in  many  copies  for  future  gen- 
erations, until  the  printing  press  came  to  perpetuate 
them. 

Of  this  there  is  abundant  evidence  in  the  preced- 
ing pages  as  regards  medicine,  and,  above  all, 
surgery,  while  a  summary  of  accomplishments  of 
workers  in  other  departments  will  be  found  in  Ap- 
pendix II,  "  Science  at  the  Medieval  Universities." 

At  the  beginning  of  the  twentieth  century,  with 
some  of  the  supposed  foundations  of  modern  chem- 
istry crumbling  to  pieces  under  the  influence  of  the 
peculiarly  active  light  thrown  upon  our  nineteenth 
century  chemical  theories  by  the  discovery  of 
radium,  and  our  observations  on  radio-active  ele- 
ments generally,  there  is  a  reawakening  of  interest 


BASIL  VALENTINE  351 

in  some  of  the  old-time  chemical  observers,  whose 
work  used  to  be  laughed  at  as  so  unscientific,  or,  at 
most,  but  a  caricature  of  real  science,  and  whose 
theory  of  the  transmutation  of  elements  into  one 
another  was  considered  so  absurd.  It  is  interesting 
in  the  light  of  this  to  recall  that  the  idea  that  the 
elementary  substances  were  essentially  distinct 
from  each  other,  and  that  it  would  be  impossible  un- 
der any  circumstances  to  convert  one  element  into 
another,  belongs  entirely  to  the  nineteenth  century. 
Even  so  deeply  scientific  a  mind  as  that  of  Newton, 
in  the  preceding  century,  could  not  bring  itself  to 
acknowledge  the  tradition,  that  came  to  be  accepted 
subsequent  to  his  time,  of  the  absurdity  of  metallic 
transformation.  On  the  contrary,  he  believed  quite 
formally  in  transmutation  as  a  basic  chemical  prin- 
ciple, and  declared  that  it  might  be  expected  to  occur 
at  any  time.  He  had  seen  specimens  of  gold  ores  in 
connection  with  metallic  copper,  and  concluded  that 
this  was  a  manifestation  of  the  natural  transforma- 
tion of  one  of  these  yellow  metals  into  the  other,  v-^ 
With  the  discovery  that  radium  transforms  itself 
into  helium,  and  that,  indeed,  all  the  so-called  radio- 
activities of  the  heavy  metals  are  probably  due  to  a 
natural  transmutation  process  constantly  at  work, 
the  ideas  of  the  older  chemists  cease  entirely  to  be  a 
subject  for  amusement.  The  physical  chemists  of 
the  present  day  are  very  ready  to  admit  that  the 
old  teaching  of  the  absolute  independence  of  some- 
thing over  seventy  elements  is  no  longer  tenable, 
except  as  a  working  hypothesis.  The  doctrine  of 
"  matter  and  form,"  taught  for  so  many  centuries 
by  the   scholastic  philosophers,  which  proclaimed 


352  OLD-TIME  MAKEES  OF  MEDICINE 

that  all  matter  is  composed  of  two  principles,  an 
underlying  material  substratum,  and  a  dynamic  or 
informing  principle,  has  now  more  acknowledged 
verisimilitude,  or  lies  at  least  closer  to  the  gener- 
ally accepted  ideas  of  the  most  progressive  sci- 
entists, than  it  has  at  any  time  for  the  last  two  or 
three  centuries.  Not  only  the  great  physicists,  but 
also  the  great  chemists,  are  speculating  along  lines 
that  suggest  the  existence  of  but  one  form  of  mat- 
ter, modified  according  to  the  energies  that  it  pos- 
sesses under  a  varying  physical  and  chemical  en- 
vironment. This  is,  after  all,  only  a  restatement  in 
modern  times  of  the  teaching  of  St.  Thomas  of 
Aquin,  in  the  thirteenth  century. 

It  is  not  surprising,  then,  that  there  should  be  a 
reawakening  of  interest  in  the  lives  of  some  of  the 
men,  who,  dominated  by  some  of  the  earlier  scho- 
lastic ideas,  by  the  tradition  of  the  possibility  of 
finding  the  philosopher's  stone,  which  would  trans- 
mute the  baser  metals  into  the  precious  metals,  de- 
voted themselves  with  quite  as  much  zeal  as  any 
modern  chemist  to  the  observation  of  chemical 
phenomena.  One  of  the  most  interesting  of  these — 
indeed,  he  might  well  be  said  to  be  the  greatest  of 
the  alchemists — is  the  man  whose  only  name  that  we 
know  is  that  which  appears  on  a  series  of  manu- 
scripts written  in  the  High  German  dialect  of  the 
end  of  the  fifteenth  and  the  beginning  of  the  six- 
teenth century.  That  name  is  Basil  Valentine,  and 
the  writer,  according  to  the  best  historical  tradi- 
tions, was  a  Benedictine  monk.  The  name  Basil 
Valentine  may  only  have  been  a  pseudonym,  for  it 
has  been  impossible  to  trace  it  among  the  records  of 


BASIL  VALENTINE  353 

the  monasteries  of  the  time.  That  the  writer  was 
a  monk,  however,  there  seems  to  be  no  room  for 
doubt,  for  his  writings  give  abundant  evidence  of  it, 
and,  besides,  in  printed  form  they  began  to  have 
their  vogue  at  a  time  when  there  was  little  likelihood 
of  their  being  attributed  to  a  monastic  source,  un- 
less an  indubitable  tradition  connected  them  with 
some  monastery. 

This  Basil  Valentine  (to  accept  the  only  name  we 
have)  did  so  much  for  the  science  of  the  composition 
of  substances  that  he  eminently  deserves  the  desig- 
nation that  has  been  given  him  of  the  last  of  the 
alchemists  and  the  first  of  the  chemists.  There  is 
practically  a  universal  recognition  of  the  fact  now 
that  he  deserves  also  the  title  of  the  Founder  of 
Pharmaceutical  Chemistry,  not  only  because  of  the 
value  of  the  observations  contained  in  his  writings, 
but  also  because  of  the  fact  that  they  proved  so  sug- 
gestive to  certain  scientific  geniuses  during  the  cen- 
tury succeeding  Valentine's  life.  Almost  more  than 
to  have  added  to  the  precious  heritage  of  knowledge 
for  mankind,  it  is  a  boon  for  a  scientific  observer  to 
have  awakened  the  spirit  of  observation  in  others, 
and  to  be  the  founder  of  a  new  school  of  thought. 
This  Basil  Valentine  undoubtedly  did,  and,  in  the 
Eenaissance,  the  incentive  from  his  writings  for 
such  men  as  Paracelsus  is  easy  to  appreciate. 

Besides,  his  work  furnishes  evidence  that  the  in- 
vestigating spirit  was  abroad  just  when  it  is  usually 
supposed  not  to  have  been,  for  the  Thuringian  monk 
surely  did  not  do  all  his  investigation  alone,  but 
must  have  .owed,  as  well  as  given,  many  a  suggestion 
to  his  contemporaries. 


354  OLD-TIME  MAKERS  OF  MEDICINE 

Some  ten  years  ago,  when  Sir  Michael  Foster, 
professor  of  physiology  in  the  University  of  Cam- 
bridge, England,  was  invited  to  deliver  the  Lane 
Lectures  at  the  Cooper  Medical  College  in  San  Fran- 
cisco, he  took  for  his  subject  "  The  History  of 
Physiology."  In  the  course  of  his  lecture  on  "  The 
Eise  of  Chemical  Physiology  "  he  began  with  the 
name  of  Basil  Valentine,  who  first  attracted  men's 
attention  to  the  many  chemical  substances  around 
them  that  might  be  used  in  the  treatment  of  disease, 
and  said  of  him : 

"  He  was  one  of  the  alchemists,  but  in  addition  to 
his  inquiries  into  the  properties  of  metals  and  his 
search  for  the  philosopher's  stone,  he  busied  himself 
with  the  nature  of  drugs,  vegetable  and  mineral,  and 
with  their  action  as  remedies  for  disease.  He  was 
no  anatomist,  no  physiologist,  but  rather  what  now- 
adays we  should  call  a  pharmacologist.  He  did  not 
care  for  the  problem  of  the  body,  all  he  sought  to 
understand  was  how  the  constituents  of  the  soil  and 
of  plants  might  be  treated  so  as  to  be  available  for 
healing  the  sick  and  how  they  produced  their  effects. 
We  apparently  owe  to  him  the  introduction  of  many 
chemical  substances,  for  instance  of  hydrochloric 
acid,  which  he  prepared  from  oil  and  vitriol  of  salt, 
and  of  many  vegetable  drugs.  And  he  was  appar- 
ently the  author  of  certain  conceptions  which,  as  we 
shall  see,  played  an  important  part  in  the  develop- 
ment of  chemistry  and  of  physiology.  To  him,  it 
seems,  we  owe  the  idea  of  the  three  '  elements,'  as 
they  were  and  have  been  called,  replacing  the  old 
idea  of  the  ancients  of  the  four  elements — earth,  air, 
fire,  and  water.  It  must  be  remembered,  however, 
that  both  in  the  ancient  and  the  new  idea  the  word 
'  element  '  was  not  intended  to  mean  that  which  it 
means  to  us  now,  a  fundamental  unit  of  matter,  but 


BASIL  VALENTINE  355 

a  general  quality  or  property  of  matter.  The  three 
elements  of  Valentine  were:  (1)  sulphur,  or  that 
which  is  combustible,  which  is  changed  or  destroyed, 
or  which  at  all  events  disappears  during  burning  or 
combustion;  (2)  mercury,  that  which  temporarily 
disappears  during  burning  or  combustion,  which  is 
dissociated  in  the  burning  from  the  body  burnt,  but 
which  may  be  recovered,  that  is  to  say,  that  which  is 
volatile,  and  (3)  salt,  that  which  is  fixed,  the  residue 
or  ash  which  remains  after  burning. ' ' 

It  is  a  little  bit  hard  in  our  time  for  most  people 
to  understand  just  how  such  a  development  of  thor- 
oughly scientific  chemical  notions,  with  investiga- 
tions for  their  practical  application,  should  have 
come  before  the  end  of  the  Middle  Ages.  This  diffi- 
culty of  understanding,  however,  we  are  coming  to 
realize  in  recent  years,  is  entirely  due  to  our  ig- 
norance of  the  period.  We  have  known  little  or 
nothing  about  the  science  of  the  Middle  Ages,  be- 
cause it  was  hidden  away  in  rare  old  books,  in  rather 
difficult  Latin,  not  easy  to  get  at,  and  still  less  easy 
to  understand  always,  and  we  have  been  prone  to 
conclude  that  since  we  knew  nothing  about  it,  there 
must  have  been  nothing.  Just  inasmuch  as  we  have 
learned  something  definite  about  the  medieval 
scholars,  our  admiration  has  increased.  Professor 
Clifford  Allbutt,  the  Eegius  Professor  of  Medicine 
at  the  University  of  Cambridge,  in  his  Harveian 
Oration,  delivered  before  the  Eoyal  College  of  Phy- 
sicians in  1900,  on  "  Science  and  Medieval 
Thought  "  (London,  1901),  declared  that  "  the 
schoolmen,  in  digging  for  treasure,  cultivated  the 
field  of  knowledge  even  for  Galileo  and  Harvey,  for 
Newton  and  Darwin.' '    He  might  have  added  that 


356  OLD-TIME  MAKERS  OF  MEDICINE 

they  had  laid  foundations  in  all  our  modern  sciences, 
in  chemistry  quite  as  well  as  in  astronomy,  physi- 
ology, and  the  medical  sciences,  in  mathematics  and 
botany. 

In  chemistry  the  advances  made  during  the 
thirteenth,  fourteenth,  and  fifteenth  centuries  were, 
perhaps,  even  more  noteworthy  than  those  in  any 
other  department  of  science.  Albertus  Magnus,  who 
taught  at  Paris,  wrote  no  less  than  sixteen  treatises 
on  chemical  subjects,  and,  notwithstanding  the  fact 
that  he  was  a  theologian  as  well  as  a  scientist,  and 
that  his  printed  works  fill  some  fifteen  folio  volumes, 
he  somehow  found  the  time  to  make  many  observa- 
tions for  himself,  and  performed  numberless  ex- 
periments in  order  to  clear  up  doubts.  The  larger 
histories  of  chemistry  accord  him  his  proper  place, 
and  hail  him  as  a  great  founder  in  chemistry,  and  a 
pioneer  in  original  investigation. 

Even  St.  Thomas  of  Aquin,  much  as  he  was  oc- 
cupied with  theology  and  philosophy,  found  some 
time  to  devote  to  chemical  questions.  After  all, 
this  is  only  what  might  have  been  expected  of  the 
favorite  pupil  of  Albertus  Magnus.  Three  treatises 
on  chemical  subjects  from  Aquinas'  pen  have  been 
preserved  for  us,  and  it  is  to  him  that  we  are  said 
to  owe  the  use,  in  the  Western  world  at  least,  of  the 
word  amalgam,  which  he  first  employed  in  describ- 
ing various  chemical  methods  of  metallic  combina- 
tion with  mercury  that  were  discovered  in  the  search 
for  the  genuine  transmutation  of  metals. 

Albertus  Magnus'  other  great  scientific  pupil, 
Eoger  Bacon,  the  English  Franciscan  friar,  followed 
more  closely  in  the   scientific  ways   of  his  great 


BASIL  VALENTINE  357 

master,  devoting  himself  almost  entirely  to  the 
physical  sciences.  Altogether  he  wrote  some 
eighteen  treatises  on  chemical  subjects.  For  a  long 
time  it  was  considered  that  he  was  the  inventor  of 
gunpowder,  though  this  is  now  known  to  have  been 
introduced  into  Europe  by  the  Arabs.  Roger  Ba- 
con studied  gunpowder  and  various  other  explosive 
combinations  in  considerable  detail,  and  it  is  for  this 
reason  that  he  obtained  the  undeserved  reputation 
of  being  an  original  discoverer  in  this  line.  How 
well  he  realized  how  much  might  be  accomplished  by 
means  of  the  energy  stored  up  in  explosives,  can, 
perhaps,  be  best  appreciated  from  the  fact  that  he 
suggested  that  boats  would  go  along  the  rivers  and 
across  seas  without  either  sails  or  oars,  and  that 
carriages  would  go  along  the  streets  without  horse 
or  man  power.  He  considered  that  man  would 
eventually  invent  a  method  of  harnessing  these  ex- 
plosive mixtures,  and  of  utilizing  their  energies  for 
his  purposes  without  danger.  It  is  curiously  inter- 
esting to  find,  as  we  begin  the  twentieth  century,  and 
gasolene  is  so  commonly  used  for  the  driving  of 
automobiles  and  motor  boats,  and  is  being  introduced 
even  into  heavier  transportation  as  the  most  avail- 
able source  of  energy  for  suburban  traffic,  at  least, 
that  this  generation  should  only  be  fulfilling  the  idea 
of  the  old  Franciscan  friar  of  the  thirteenth  century, 
who  prophesied  that  in  explosives  there  was  the 
secret  of  eventually  manageable  energy  for  trans- 
portation purposes. 

Succeeding  centuries  were  not  as  fruitful  in  great 
scientists  as  the  thirteenth,  and  yet,  in  the  second 
half  of  the  thirteenth,  there  was  a  Pope,  John  XXI, 


358  OLD-TIME  MAKERS  OF  MEDICINE 

who  had  been  a  physician  and  professor  of  medicine 
before  his  election  to  the  Papacy,  three  of  whose 
scientific  treatises — one  on  the  transmutation  of 
metals,  which  he  considers  an  impossibility,  at  least 
as  far  as  the  manufacture  of  gold  and  silver  was 
concerned;  a  treatise  on  diseases  of  the  eyes,  to 
which  good  authorities  have  not  hesitated  to  give 
lavish  praise  for  its  practical  value,  considering  the 
conditions  in  which  it  was  written ;  and,  finally,  his 
treatise  on  the  preservation  of  the  health,  written 
when  he  was  himself  over  eighty  years  of  age — 
are  all  considered  by  good  authorities  as  worthy  of 
the  best  scientific  spirit  of  the  time. 

During  the  fourteenth  century,  Arnold  of  Vil- 
lanova,  the  inventor  of  nitric  acid,  and  the  two  Hol- 
landuses,  kept  up  the  tradition  of  original  investiga- 
tion in  chemistry.  Altogether  there  are  some 
dozen  treatises  from  these  three  men  on  chemical 
subjects.  The  Hollanduses  particularly  did  their 
work  in  a  spirit  of  thoroughly  frank,  original  in- 
vestigation. They  were  more  interested  in  min- 
erals than  in  any  other  class  of  substances,  but  did 
not  waste  much  time  on  the  question  of  transmuta- 
tion of  metals.  Professor  Thompson,  the  professor 
of  chemistry  at  Edinburgh,  said,  in  his  ' '  History  of 
Chemistry,"  many  years  ago,  that  the  Hollanduses 
give  very  clear  descriptions  of  their  processes  of 
treating  minerals  in  investigating  their  composition, 
and  these  serve  to  show  that  their  knowledge  was 
by  no  means  entirely  theoretical,  or  acquired  only 
from  books. 

It  is  not  surprising,  then,  to  have  a  great  in- 
vestigating  pharmacologist   come   along   sometime 


BASIL  VALENTINE  359 

about  the  beginning  of  the  fifteenth  century,  when, 
according  to  the  best  authorities,  Basil  Valentine 
was  born.  From  traditions  he  seems  to  have  had  a 
rather  long  life,  and  his  years  run  nearly  parallel 
with  his  century.  His  career  is  a  typical  example 
of  the  personally  obscure  and  intellectually  bril- 
liant lives  which  the  old  monks  lived.  Probably 
in  nothing  have  recent  generations  been  more  de- 
ceived in  historical  matters  than  in  their  estimation 
of  the  intellectual  attainments  and  accomplishment 
of  the  old  monks.  The  more  that  we  know  of  them, 
not  from  second-hand  authorities,  but  from  their 
own  books  and  from  what  they  accomplished  in  art 
and  architecture,  in  agriculture,  in  science  of  all 
kinds,  the  more  do  we  realize  what  busy  men  they 
were,  and  appreciate  what  genius  they  often  brought 
to  the  solution  of  great  problems.  We  have  had 
much  negative  pseudo-information  brought  together 
with  the  definite  purpose  of  discrediting  monasti- 
cism,  and  now  that  positive  information  is  gradu- 
ally being  accumulated,  it  is  almost  a  shock  to  find 
how  different  are  the  realities  of  the  story  of  the 
intellectual  life  during  the  Middle  Ages  from  what 
many  writers  had  pictured  them. 

To  those  who  may  be  surprised  that  a  man  who 
did  great  things  in  medicine  should  have  lived  dur- 
ing the  fifteenth  century,  it  may  be  well  to  recall 
the  names  and  a  little  of  the  accomplishment  of  the 
men  of  this  period,  who  were  Basil  Valentine's  con- 
temporaries, at  least  in  the  sense  that  some  portion 
of  their  lives  and  influence  was  coeval  with  his. 
Before  the  end  of  this  century  Columbus  had  dis- 
covered America,  and  by  no  happy  accident,  for 


360  OLD-TIME  MAKEES  OF  MEDICINE 

many  men  of  his  generation  did  correspondingly- 
great  work.  Cardinal  Nicholas  of  Cusa  had  de- 
veloped mathematics  and  applied  mathematical 
ideas  to  the  heavens,  so  that  he  could  announce  the 
conclusion  that  the  earth  was  a  star,  like  the  other 
stars,  and  moved  in  the  heavens  as  they  do.  Con- 
temporary with  Cusanus  was  Eegiomontanus,  who 
has  been  proclaimed  the  father  of  modern  astron- 
omy, and  a  distinguished  mathematician.  Tos- 
canelli,  the  Florentine  astronomer,  whose  years  run 
almost  parallel  with  those  of  the  fifteenth  century, 
did  fine  scholarly  work,  which  deeply  influenced  Co- 
lumbus and  the  great  navigators  of  the  time.  The 
universities  in  Italy  were  attracting  students  from 
all  over  Europe,  and  such  men  as  Linacre  and  Dr. 
Caius  went  down  there  from  England.  Eaphael 
was  but  a  young  man  at  the  end  of  the  century,  but 
he  had  done  some  noteworthy  painting  before  it 
closed.  Leonardo  da  Vinci  was  born  just  about 
the  middle  of  the  century,  and  did  some  marvellous 
work  before  the  end  of  that  century.  Michael 
Angelo  was  only  twenty-five  at  the  close  of  the 
century,  but  he,  too,  did  fine  work,  even  at  this 
early  age.  Among  the  other  great  Italian  painters 
of  this  century  are  Fra  Angelico,  Perugino, 
Eaphael 's  master,  Pinturicchio,  Signorelli,  the  pupil 
of  his  uncle,  Vasari,  almost  as  distinguished,  Botti- 
celli, Titian,  and  very  many  others,  who  would  have 
been  famous  leaders  in  art  in  any  other  but  this 
supremely  great  period. 

It  was  not  only  in  Italy,  however,  that  there  was 
a  wonderful  outburst  of  genius  at  this  time,  for 
Germany  also  saw  the  rise  of  a  number  of  great 


BASIL  VALENTINE  361 

men  during  this  period.  Jacob  Wimpheling,  the 
"  Schoolmaster  of  Germany,' '  as  he  has  been  called, 
whose  educational  work  did  much  to  determine  the 
character  of  German  education  for  two  centuries, 
was  born  in  1450.  Eudolph  Agricola,  who  in- 
fluenced the  intellectual  Europe  of  this  time  deeply, 
was  born  in  1443.  Erasmus,  one  of  the  greatest  of 
scholars,  of  teachers,  and  of  controversialists,  was 
born  in  1467.  Johann  Eeuchlin,  the  great  linguist, 
who,  next  to  Erasmus,  is  the  most  important  char- 
acter in  the  German  Eenaissance,  was  born  in  1455. 
Then  there  was  Sebastian  Brant,  the  author  of  ' '  The 
Ship  of  Fools,' '  and  Alexander  Hegius,  both  of  this 
same  period.  The  most  influential  of  them  all, 
Thomas  a  Kempis,  who  died  in  1471,  and  whose 
little  book,  "  The  Following  of  Christ,' '  has  in- 
fluenced every  generation  deeply  ever  since,  was 
probably  a  close  contemporary  of  Basil  Valentine. 
When  one  knows  what  European,  and  especially 
German  scholars,  were  accomplishing  at  this  time, 
no  room  is  left  for  surprise  that  Basil  Valentine 
should  have  lived  and  done  work  in  medicine  at  this 
period  that  was  to  influence  deeply  the  after  history 
of  medicine. 

Most  of  what  Basil  Valentine  did  was  accom- 
plished in  the  first  half  of  the  fifteenth  century. 
Coming,  as  he  did,  before  the  invention  of  printing, 
when  the  spirit  of  tradition  was  more  rife  and  dom- 
inating than  it  has  been  since,  it  is  almost  needless  to 
say  that  there  are  many  curious  legends  associated 
with  his  name.  Two  centuries  before  his  time, 
Eoger  Bacon,  doing  his  work  in  England,  had  suc- 
ceeded in  attracting  so  much  attention  even  from 


362  OLD-TIME  MAKEES  OF  MEDICINE 

the  common  people,  because  of  his  wonderful  sci- 
entific discoveries,  that  his  name  became  a  byword, 
and  many  strange  magical  feats  were  attributed  to 
him.  Friar  Bacon  was  the  great  wizard,  even  in 
the  plays  of  the  Elizabethan  period.  A  number  of 
the  same  sort  of  myths  attached  themselves  to  the 
Benedictine  monk  of  the  fifteenth  century.  He  was 
proclaimed  in  popular  story  to  have  been  a  won- 
derful magician.  Even  his  manuscript,  it  was  said, 
had  not  been  published  directly,  but  had  been  hid- 
den in  a  pillar  in  the  church  attached  to  his 
monastery,  and  had  been  discovered  there  after  the 
splitting  open  of  the  pillar  by  a  bolt  of  lightning 
from  heaven.  It  is  the  extension  of  this  tradition 
that  has  sometimes  led  to  the  assumption  that  Val- 
entine lived  in  an  earlier  century,  some  even  going 
so  far  as  to  say  that  he,  too,  like  Boger  Bacon,  was 
a  product  of  the  thirteenth  century.  It  seems  rea- 
sonably possible,  however,  to  separate  the  tradi- 
tional from  what  is  actual  in  his  existence,  and  thus 
to  obtain  some  idea  at  least  of  his  work,  if  not  of 
the  details  of  his  life.  The  internal  evidence  from 
his  works  enables  the  historian  of  science  to  place  his 
writing  within  half  a  century  of  the  discovery  of 
America. 

One  of  the  myths  that  have  gathered  around  the 
name  of  Basil  Valentine,  because  it  has  become  a 
commonplace  in  philology,  has  probably  made  him 
more  generally  known  than  any  of  his  actual  dis- 
coveries. In  one  of  the  most  popular  of  the  old- 
fashioned  text-books  of  chemistry  in  use  about  half 
a  century  ago,  in  the  chapter  on  antimony,  there 
was  a  story  that  students,  if  I  may  judge  from  my 


BASIL  VALENTINE  363 

own  experience,  never  forgot.     It  was   said  that 
Basil  Valentine,  a  monk  of  the  Middle  Ages,  was 
the  discoverer  of  this  substance.    After  having  ex- 
perimented with  it  in  a  number  of  ways,  he  threw 
some  of  it  ont  of  his  laboratory  one  day  when  the 
swine  of  the  monastery,  finding  it,  proceeded  to  gob- 
ble it  up,  together  with  some  other  refuse.  Just  when 
they  were  finishing  it,  the  monk  discovered  what  they 
were  doing.    He  feared  the  worst  from  it,  but  took 
the  occasion  to  observe  the  effect  upon  the  swine 
very  carefully.    He  found  that,  after  a  preliminary 
period   of   digestive   disturbance,   these   swine   de- 
veloped an  enormous  appetite,  and  became  fatter 
than  any  of  the  others.     This  seemed  a  rather  de- 
sirable  result,   and  Basil  Valentine,   ever   on   the 
search  for  the  practical,  thought  that  he  might  use 
the  remedy  to  good  purpose  on  the  members  of  the 
community.     Some  of  the  monks  in  the  monastery 
were  of  rather  frail  health  and  delicate  constitution, 
and  most  of  them  were  rather  thin,  and  he  thought 
that  the  putting  on  of  a  little  fat,  provided  it  could 
be  accomplished  without  infringement  of  the  rule, 
might  be  a  good  thing  for  them.    Accordingly,  he 
administered,  surreptitiously,  some  of  the  salts  of 
antimony,  with  which  he  was  experimenting,  in  the 
food  served  to  these  monks.     The  result,  however, 
was  not  so  favorable  as  in  the  case  of  the  hogs.    In- 
deed, according  to  one,  though  less  authentic,  ver- 
sion of  the  story,  some  of  the  poor  monks,  the  un- 
conscious subjects  of  the  experiment,  perished  as 
the  result  of  the  ingestion  of  the  antimonial  com- 
pounds.   According  to  the  better  version,  they  suf- 
fered only  the  usual  unpleasant  consequences   of 


364  OLD-TIME  MAKEES  OF  MEDICINE 

taking  antimony,  which  are,  however,  quite  enough 
for  a  fitting  climax  to  the  story.  Basil  Valentine 
called  the  new  substance  which  he  had  discovered 
antimony,  that  is,  opposed  to  monks.  It  might  be 
good  for  hogs,  but  it  was  a  form  of  monks'  bane,  as 
it  were.1 

Unfortunately  for  most  of  the  good  stories  of 
history,  modern  criticism  has  nearly  always  failed 
to  find  any  authentic  basis  for  them,  and  they  have 
had  to  go  the  way  of  the  legends  of  Washington's 
hatchet  and  TelPs  apple.  We  are  sorry  to  say  that 
that  seems  to  be  true  also  of  this  particular  story. 
Antimony,  the  word,  is  very  probably  derived  from 
certain  dialectic  forms  of  the  Greek  word  for  the 
metal,  and  the  name  is  no  more  derived  from  anti 
and  monachus  than  it  is  from  anti  and  monos  (op- 
posed to  single  existence),  another  fictitious  deriva- 
tion that  has  been  suggested,  and  one  whose  etymo- 
logical value  is  supposed  to  consist  in  the  fact  that 
antimony  is  practically  never  found  alone  in  nature. 

Notwithstanding  the  apparent  cloud  of  unfounded 
traditions  that  are  associated  with  his  name,  there 

1  It  is  curious  to  trace  how  old  are  the  traditions  on  which  some  of 
these  old  stories,  that  must  now  be  rejected,  are  founded.  I  have  come 
upon  the  story  with  regard  to  Basil  Valentine  and  the  antimony  and 
the  monks  in  an  old  French  medical  encyclopedia  of  biography,  published 
in  the  seventeenth  century,  and  at  that  time  there  was  no  doubt  at  all 
expressed  as  to  its  truth.  How  much  older  than  this  it  may  be  I  do  not 
know,  though  it  is  probable  that  it  comes  from  the  sixteenth  century, 
when  the  Tcakoethes  scribendi  attacked  many  people  because  of  the  facil- 
ity of  printing,  and  when  most  of  the  good  stories  that  have  so  worried 
the  modern  dry-as-dust  historian  in  his  researches  for  their  correction 
became  a  part  of  the  body  of  supposed  historical  tradition.  It  is  prob- 
ably French  in  origin  because  in  that  language  antimoine  is  a  tempting 
bait  for  that  pseudo-philology  which  has  so  often  led  to  false  derivations. 


BASIL  VALENTINE  365 

can  be  no  doubt  at  all  of  the  fact  that  Valentinus — 
to  give  him  the  Latin  name  by  which  he  is  commonly 
designated  in  foreign  literatures — was  one  of  the 
great  geniuses,  who,  working  in  obscurity,  make 
precious  steps  into  the  unknown  that  enable  human- 
ity after  them  to  see  things  more  clearly  than  ever 
before.  There  are  definite  historical  grounds  for 
placing  Basil  Valentine  as  the  first  of  the  series  of 
careful  observers  who  differentiated  chemistry  from 
the  old  alchemy  and  applied  its  precious  treasures 
of  information  to  the  uses  of  medicine.  It  is  said 
to  have  been  because  of  the  study  of  Basil  Valen- 
tine's work  that  Paracelsus  broke  away  from  the 
Galenic  traditions,  so  supreme  in  medicine  up  to  his 
time,  and  began  our  modern  pharmaceutics.  Fol- 
lowing Paracelsus  came  Van  Helmont,  the  father 
of  modern  medical  chemistry,  and  these  three  did 
more  than  any  others  to  enlarge  the  scope  of  medica- 
tion and  to  make  observation  rather  than  authority 
the  most  important  criterion  of  truth  in  medicine. 
Indeed,  the  work  of  this  trio  of  men  of  the  fifteenth 
and  sixteenth  centuries — the  Eenaissance  in  medi- 
cine as  in  art — dominated  medical  treatment,  or  at 
least  the  department  of  pharmaceutics,  down  almost 
to  our  own  day,  and  their  influence  is  still  felt  in 
drug-giving. 

While  we  do  not  know  the  absolute  data  of  either 
the  birth  or  the  death  of  Basil  Valentine  and  are 
not  sure  of  the  exact  period  even  in  which  he  lived 
and  did  his  work,  we  are  sure  that  a  great  original 
observer  about  the  time  of  the  invention  of  printing 
studied  mercury  and  sulphur  and  various  salts  of 
the  metals,  and  above  all  introduced  antimony  to 


366  OLD-TIME  MAKERS  OF  MEDICINE 

the  notice  of  the  scientific  world,  and  especially  to 
the  favor  of  practitioners  of  medicine.  His  book, 
"  The  Triumphal  Chariot  of  Antimony,' '  is  full  of 
conclusions  not  quite  justified  by  his  premises  nor 
by  his  observations.  There  is  no  doubt,  however, 
that  the  observational  method  which  he  employed 
furnished  an  immense  amount  of  knowledge,  and 
formed  the  basis  of  the  method  of  investigation  by 
which  the  chemical  side  of  medicine  was  to  develop 
during  the  next  two  or  three  centuries.  Great  harm 
was  done  by  the  abuse  of  antimony,  but  then  great 
harm  is  done  by  the  abuse  of  anything,  no  matter 
how  good  it  may  be.  For  a  time  it  came  to  be  the 
most  important  drug  in  medicine  and  was  only  re- 
placed by  venesection. 

The  fact  of  the  matter  is  that  doctors  were  looking 
for  effects  from  their  drugs,  and  antimony  is,  above 
all  things,  effective.  Patients,  too,  wished  to  see  the 
effect  of  the  medicines  they  took.  They  do  so  even 
yet,  and  when  antimony  was  administered  there  was 
no  doubt  about  its  working. 

The  most  interesting  of  Basil  Valentine's  books, 
and  the  one  which  has  had  the  most  enduring  in- 
fluence, is  undoubtedly  "  The  Triumphal  Chariot 
of  Antimony."1    It  has  been  translated  and  has 

1  There  is  in  the  New  York  Academy  of  Medicine  a  thick  24mo 
volume  in  which  three  of  the  classics  of  older  medicine  are  bound 
together.  They  are  Kerckringius's  "  Commentary  on  the  Triumphal 
Chariot  of  Antimony,"  published  at  Amsterdam,  1671;  Steno's 
"  Dissertation  on  the  Anatomy  of  the  Brain,"  published  in  Leyden 
in  1671,  and  Father  Kircher's  "  Scrutinium  Physico  Contagiosae 
Luis  quae  dicitur  Pestis  "  ( Physico-medical  Discussions  of  the  Con- 
tagious Disease  which  is  called  Pest).  This  was  published  at  Leipzig 
in  1659.    Just  how  the  three  works  came  to  be  bound  together  is  hard 


BASIL  VALENTINE  367 

had  a  wide  vogue  in  every  language  of  modern 
Europe.  Its  recommendation  of  antimony  had  such 
an  effect  upon  medical  practice  that  it  continued 
to  be  the  most  important  drug  in  the  pharmacopoeia 
down  almost  to  the  middle  of  the  nineteenth  century. 
If  any  proof  were  needed  that  Basil  Valentine  or 
that  the  author  of  the  books  that  go  under  the  name 
was  a  monk  it  would  be  found  in  the  introduction 
to  this  volume,  which  not  only  states  that  fact  very 
clearly,  but  also  in  doing  so  makes  use  of  language 
that  shows  the  writer  to  have  been  deeply  imbued 
with  the  old  monastic  spirit.  I  quote  the  first  para- 
graph of  this  introduction  because  it  emphasizes  this. 
The  quotation  is  taken  from  the  English  translation 
of  the  work  as  published  in  London  in  1678.  Curi- 
ously enough,  seeing  the  obscurity  surrounding  Val- 
entine himself,  we  do  not  know  for  sure  who  made 
the  translation.  The  translator  apologizes  some- 
what for  the  deeply  religious  spirit  of  the  book, 
but  considers  that  he  was  not  justified  in  eliminating 

to  say.  Very  probably  they  belonged  to  some  old-time  scholar,  though 
there  is  nothing  about  the  books  to  tell  anything  of  the  story.  The 
fact  that  all  three  of  the  authors  were  ecclesiastics  of  the  Catholic 
Church,  Valentine  a  Monk,  Steno  a  Bishop,  and  Kircher  a  Jesuit, 
would  seem  to  be  one  common  bond  and  perhaps  a  reason  for  the 
binding  of  these  rather  disparate  treatises  together.  In  that  case 
it  is  probable  that  the  book  came  from  an  old  monastic  library 
dispersed  after  the  suppression  of  the  order  by  some  government. 
It  seems  not  unlikely  that  the  volume  belonged  at  some  time  to  an 
old  Jesuit  library,  for  they  have  suffered  the  most  in  that  way. 
That  these  three  classics  of  medicine  should  have  been  republished 
in  handy  volume  editions  within  practically  ten  years  shows  an 
interest  in  medical  literature  that  has  not  existed  again  until  our 
own  time,  for  during  the  eighteenth  and  early  nineteenth  centuries 
there  was  almost  utter  neglect  of  them. 


368  OLD-TIME  MAKERS  OF  MEDICINE 

any  of  this.  The  paragraph  is  left  in  the  quaint, 
old-fashioned  form  so  eminently  snited  to  the 
thoughts  of  the  old  master,  and  the  spelling  and 
use  of  capitals  is  not  changed. 

1 '  Basil  Valentine :  His  Triumphant  Chariot  of 
Antimony. — Since  I,  Basil  Valentine,  by  Eeligious 
Vows  am  bound  to  live  according  to  the  order  of  St. 
Benedict  and  that  requires  another  manner  of  Spirit 
of  Holiness  than  the  common  state  of  Mortals  exer- 
cised in  the  profane  business  of  this  World;  I 
thought  it  my  duty  before  all  things,  in  the  beginning 
of  this  little  book,  to  declare  what  is  necessary  to  be 
known  by  the  pious  Spagyrist  [old-time  name  for 
medical  chemist],  inflamed  with  an  ardent  desire  of 
this  Art,  as  what  he  ought  to  do,  and  whereunto  to 
direct  his  striving,  that  he  may  lay  such  foundations 
of  the  whole  matter  as  may  be  stable ;  lest  his  Build- 
ing, shaken  with  the  Winds,  happen  to  fall,  and  the 
whole  Edifice  to  be  involved  in  shameful  Euine 
which  otherwise  being  founded  on  more  firm  and 
solid  principles,  might  have  continued  for  a  long 
series  of  time.  Which  Admonition  I  judged  was, 
is  and  always  will  be  a  necessary  part  of  my  re- 
ligious Office;  especially  since  we  must  all  die,  and 
no  one  of  us  which  are  now,  whether  high  or  low, 
shall  long  be  seen  among  the  number  of  men.  For 
it  concerns  me  to  recommend  these  Meditations  of 
Mortality  to  Posterity,  leaving  them  behind  me,  not 
only  that  honor  may  be  given  to  the  Divine  Majesty, 
but  also  that  men  may  obey  him  sincerely  in  all 
things. 

"  In  this  my  meditation  I  found  that  there  were 
five  principal  heads,  chiefly  to  be  considered  by  the 
wise  and  prudent  spectators  of  our  Wisdom  and 
Art.  The  first  of  which  is  Invocation  of  God.  The 
second,  Contemplation  of  Nature.  The  third,  True 
Preparation.    The  fourth,  the  Way  of  Using.    The 


BASIL  VALENTINE  369 

fifth,  Utility  and  Fruit.  For  lie  who  regards  not 
these,  shall  never  obtain  place  among  true  Chymists, 
or  fill  up  the  number  of  perfect  Spagyrists.  There- 
fore, touching  these  five  heads,  we  shall  here  follow- 
ing treat  and  so  far  declare  them,  as  that  the  general 
Work  may  be  brought  to  light  and  perfected  by  an 
intent  and  studious  Operator." 

This  book,  though  the  title  might  seem  to  indicate 
it,  is  not  devoted  entirely  to  the  study  of  antimony, 
but  contains  many  important  additions  to  the  chem- 
istry of  the  time.  For  instance,  Basil  Valentine  ex- 
plains in  this  work  how  what  he  calls  the  spirit  of 
salt  might  be  obtained.  He  succeeded  in  manufac- 
turing this  material  by  treating  common  salt  with 
oil  of  vitriol  and  heat.  From  the  description  of 
the  uses  to  which  he  put  the  end  product  of  his 
chemical  manipulation,  it  is  evident  that  under  the 
name  of  spirit  of  salt  he  is  describing  what  we  now 
know  as  hydrochloric  acid.  This  is  said  to  be  the 
first  definite  mention  of  it  in  the  history  of  science, 
and  the  method  suggested  for  its  preparation  is  not 
very  different  from  that  employed  even  at  the  pres- 
ent time.  He  also  suggests  in  his  volume  how  alco- 
hol may  be  obtained  in  high  strengths.  He  distilled 
the  spirit  obtained  from  wine  over  carbonate  of 
potassium,  and  thus  succeeded  in  depriving  it  of  a 
great  proportion  of  its  water.  We  have  said  that 
he  was  deeply  interested  in  the  philosopher's  stone. 
Naturally  this  turned  his  attention  to  the  study  of 
metals,  and  so  it  is  not  surprising  to  find  that  he 
succeeded  in  formulating  a  method  by  which  metallic 
copper  could  be  obtained.  The  material  used  for  the 
purpose  was  copper  pyrites,  which  was  changed  to 


370  OLD-TIME  MAKERS  OF  MEDICINE 

an  impure  sulphate  of  copper  by  the  action  of  oil 
of  vitriol  and  moist  air.  The  sulphate  of  copper 
occurred  in  solution,  and  the  copper  could  be  pre- 
cipitated from  it  by  plunging  an  iron  bar  into  it. 
Basil  Valentine  recognized  the  presence  of  this 
peculiar  yellow  metal,  and  studied  some  of  its  quali- 
ties. He  does  not  seem  to  have  been  quite  sure, 
however,  whether  the  phenomenon  that  he  witnessed 
was  not  really  a  transmutation  of  at  least  some  of 
the  iron  into  copper  as  a  consequence  of  the  other 
chemicals  present.  There  are  some  observations  on 
chemical  physiology,  and  especially  with  regard  to 
respiration,  in  the  book  on  antimony  which  show 
their  author  to  have  anticipated  the  true  explanation 
of  the  theory  of  respiration.  He  states  that  animals 
breathe  because  air  is  needed  to  support  their  life, 
and  that  all  the  animals  exhibit  the  phenomenon  of 
respiration.  He  even  insists  that  the  fishes,  though 
living  in  water,  breathe  air,  and  he  adduces  in  sup- 
port of  this  idea  the  fact  that  whenever  a  river  is 
entirely  frozen  the  fishes  die.  The  reason  for  this 
being,  according  to  this  old-time  physiological  chem- 
ist, not  that  the  fishes  are  frozen  to  death,  but  that 
they  are  not  able  to  obtain  air  in  the  ice  as  they 
did  in  the  water,  and  consequently  perish. 

There  are  many  testimonials  to  the  practical  char- 
acter of  all  his  knowledge  and  his  desire  to  apply 
it  for  the  benefit  of  humanity.  The  old  monk  could 
not  repress  the  expression  of  his  impatience  with 
physicians  who  gave  to  patients  for  "  diseases  of 
which  they  knew  little,  remedies  of  which  they  knew 
less."  For  him  it  was  an  unpardonable  sin  for  a 
physician  not  to  have  faithfully  studied  the  various 


BASIL  VALENTINE  371 

mixtures  that  lie  prescribed  for  his  patients,  and  not 
to  know  not  only  their  appearance  and  taste  and 
effect,  hut  also  the  limits  of  their  application.  Con- 
sidering that  at  the  present  time  it  is  a  frequent 
source  of  complaint  that  physicians  often  prescribe 
remedies  with  even  whose  physical  appearance  they 
are  not  familiar  and  whose  composition  is  often  quite 
unknown  to  them,  this  complaint  of  the  old-time 
chemist  alchemist  will  be  all  the  more  interesting 
for  the  modern  physician.  It  is  evident  that  when 
Basil  Valentine  allows  his  ire  to  get  the  better  of 
him  it  is  because  of  his  indignation  over  the  quacks 
who  were  abusing  medicine  and  patients  in  his  time, 
as  they  have  ever  since.  There  is  a  curious  bit  of 
aspersion  on  mere  book  learning  in  the  passage  that 
has  a  distinctly  modern  ring,  and  one  feels  the  truth 
of  Eussell  Lowell's  expression  that  to  read  a  classic, 
no  matter  how  antique,  is  like  reading  a  commentary 
on  the  morning  paper,  so  up-to-date  does  genius  ever 
remain : 

"  And  whensoever  I  shall  have  occasion  to  contend 
in  the  School  with  such  a  Doctor,  who  knows  not 
how  himself  to  prepare  his  own  medicines,  but  com- 
mits that  business  to  another,  I  am  sure  I  shall  ob- 
tain the  Palm  from  him ;  For  indeed  that  good  man 
knows  not  what  medicines  he  prescribes  to  the  sick ; 
whether  the  color  of  them  be  white,  black,  gray,  or 
blew  (sic),  he  cannot  tell;  nor  doth  this  wretched 
man  know  whether  the  medicine  he  gives  be  dry  or 
hot,  cold  or  humid ;  but  he  only  knows  that  he  found 
it  so  written  in  his  books,  and  then  pretends  to 
knowledge  or  as  it  were  Possession  by  Prescription 
of  a  very  long  time;  yet  he  desires  to  further  in- 
formation. Here  again  let  it  be  lawful  to  exclaim, 
Good  God,  to  what  a  state  is  the  matter  brought! 


372  OLD-TIME  MAKERS  OF  MEDICINE 

what  G-oodness  of  Minde  is  in  these  men !  what  care 
do  they  take  of  the  sick!  Wo,  wo  to  them!  in  the 
day  of  Judgement  they  will  find  the  fruit  of  their 
Ignorance  and  Eashness,  then  they  will  see  him 
whom  they  pierced,  when  they  neglected  their  Neigh- 
bor, sought  after  money  and  nothing  else;  whereas 
were  they  cordial  in  their  profession,  they  would 
spend  Nights  and  Days  in  Labour  that  they  might 
become  more  learned  in  their  Art,  whence  more  cer- 
tain health  would  accrew  to  the  sick  with  their  esti- 
mation and  greater  glory  to  themselves.  But  since 
Labour  is  tedious  to  them  they  commit  the  matter 
to  chance,  and  being  secure  of  their  Honour,  and 
content  with  their  Fame,  they  (like  Brawlers)  de- 
fend themselves  with  a  certain  garrulity,  without 
any  respect  had  to  Confidence  or  Truth.' ' 

Perhaps  one  of  the  reasons  why  Valentine's  book 
has  been  of  such  enduring  interest  is  that  it  is 
written  in  an  eminently  human  vein  and  out  of  a 
lively  imagination.  It  is  full  of  figures  relating  to 
many  other  things  besides  chemistry,  which  serve  to 
show  how  deeply  this  investigating  observer  was 
attentive  to  all  the  problems  of  life  around  him. 
For  instance,  when  he  wants  to  describe  the  affinity 
that  exists  between  many  substances  in  chemistry, 
and  which  makes  it  impossible  for  them  not  to  be 
attracted  to  one  another,  he  takes  a  figure  from  the 
attractions  that  he  sees  exist  among  men  and  women. 
It  is  curious  to  find  affinities  discussed  in  our  modern 
sense  so  long  ago.  There  are  some  paragraphs  with 
regard  to  the  influence  of  the  passion  of  love  that 
one  might  think  rather  a  quotation  from  an  old-time 
sermon  than  from  a  great  ground-breaking  book  in 
the  science  of  chemistry. 


BASIL  VALENTINE  373 

"  Love  leaves  nothing  entire  or  sound  in  man;  it 
impedes  his  sleep,  he  cannot  rest  either  day  or  night ; 
it  takes  off  his  appetite  that  he  hath  no  disposition 
either  to  meat  or  drink  by  reason  of  the  continual 
torments  of  his  heart  and  mind.  It  deprives  him  of 
all  Providence,  hence  he  neglects  his  affairs,  voca- 
tion, and  business.  He  minds  neither  study,  labor, 
nor  prayer ;  casts  away  all  thoughts  of  anything  but 
the  body  beloved;  this  is  his  study,  this  his  most 
vain  occupation.  If  to  lovers  the  success  be  not  an- 
swerable to  their  wish,  or  so  soon  and  prosperously 
as  they  desire,  how  many  melancholies  henceforth 
arise,  with  griefs  and  sadness,  with  which  they  pine 
away  and  wax  so  lean  as  they  have  scarcely  any  flesh 
cleaving  to  the  bones.  Yea,  at  last  they  lose  the  life 
itself,  as  may  be  proved  by  miany  examples !  for  such 
men  (which  is  an  horrible  thing  to  think  of)  slight 
and  neglect  all  perils  and  detriments,  both  of  the 
body  and  life,  and  of  the  soul  and  eternal  salvation. ' ' 

It  is  evident  that  human  nature  is  not  different 
in  our  sophisticated  twentieth  century  from  that 
which  this  observant  old  monk  saw  around  him  in 
the  fifteenth.    He  continues : 

"  How  many  testimonies  of  this  violence  which  is 
in  love,  are  daily  found?  for  it  not  only  inflames  the 
younger  sort,  but  it  so  far  exaggerates  some  persons 
far  gone  in  years  as  through  the  burning  heat 
thereof,  they  are  almost  mad.  Natural  diseases  are 
for  the  most  part  governed  by  the  complexion  of 
man  and  therefore  invade  some  more  fiercely,  others 
more  gently;  but  Love,  without  distinction  of  jpoor 
or  rich,  young  or  old,  seizeth  all,  and  having  seized 
so  blinds  them  as  forgetting  all  rules  of  reason,  they 
neither  see  nor  hear  any  snare/ ' 

But  then  the  old  monk  thinks  that  he  has  said 
enough  about  this  rather  foreign  subject,  and  apolo- 


374  OLD-TIME  MAKERS  OF  MEDICINE 

gizes  for  his  digression  in  another  paragraph  that 
should  remove  any  lingering  doubt  there  might  be 
with  regard  to  the  genuineness  of  his  monastic  char- 
acter. At  the  end  of  the  passage  he  makes  the 
application  in  a  very  few  words.  The  personal  ele- 
ment in  his  confession  is  so  naive  and  so  simply 
straightforward  that  instead  of  seeming  to  be  the 
result  of  conceit,  which  would  surely  have  repelled 
the  reader,  it  rather  attracts  and  enhances  his  kindly 
feeling  for  its  author.  The  paragraph  would  remind 
one  in  certain  ways  of  that  personal  element  that 
was  to  become  more  popular  in  literature  after 
Montaigne  in  the  next  century  made  it  rather  the 
fashion. 

"  But  of  these  enough;  for  it  becomes  not  a  re- 
ligious man  to  insist  too  long  upon  these  cogitations, 
or  to  give  place  to  such  a  flame  in  his  heart.  Hith- 
erto (without  boasting  I  speak  it)  I  have  throughout 
the  whole  course  of  my  life  kept  myself  safe  and  free 
from  it,  and  I  pray  and  invoke  God  to  vouchsafe 
me  his  Grace  that  I  may  keep  holy  and  inviolate  the 
faith  which  I  have  sworn,  and  live  contented  with 
my  spiritual  spouse,  the  Holy  Catholick  Church. 
For  no  other  reason  have  I  alleged  these  than  that 
I  might  express  the  love  with  which  all  tinctures 
ought  to  be  moved  towards  metals,  if  ever  they  be 
admitted  by  them  into  true  friendship,  and  by  love, 
which  permeates  the  inmost  parts,  be  converted  into 
a  better  state. " 

The  application  of  the  figure  at  the  end  of  his 
long  digression  is  characteristic  of  the  period  in 
which  he  wrote,  as  also  to  a  considerable  extent 
of  the  German  literary  methods  of  the  time. 

In  this  volume  on  the  use  of  antimony  there  are 


BASIL  VALENTINE  375 

in  most  of  the  editions  certain  biographical  notes 
which  have  sometimes  been  accepted  as  authentic, 
but  oftener  rejected.  According  to  these,  Basil  Val- 
entine was  born  in  a  town  in  Alsace,  on  the  southern 
bank  of  the  Ehine.  As  a  consequence  of  this,  there 
are  several  towns  that  have  laid  claim  to  being  his 
birthplace.  M.  Jean  Eeynaud,  the  distinguished 
French  philosophical  writer  of  the  first  half  of  the 
nineteenth  century,  once  said  that  Basil  Valentine, 
like  Ossian  and  Homer,  had  many  towns  claim  him 
years  after  his  death.  He  also  suggested  that,  like 
those  old  poets,  it  was  possible  that  the  writings 
sometimes  attributed  to  Basil  Valentine  were  really 
the  work  not  of  one  man,  but  of  several  individuals. 
There  are,  however,  many  objections  to  this  theory, 
the  most  forcible  of  which  is  the  internal  evidence 
derived  from  the  books  themselves  showing  similari- 
ties of  style  and  method  of  treating  subjects  too  great 
for  us  to  admit  non-identity  in  the  writers.  M. 
Eeynaud  lived  at  a  time  when  it  was  all  the  fashion 
to  suggest  that  old  works  that  had  come  down  to 
us,  like  the  Iliad  and  the  Odyssey,  and  even  such 
national  epics  as  the  Cid  and  the  Arthur  Legends 
and  the  Nibelungenlied  were  to  be  attributed  to 
several  writers  rather  than  to  one.  We  have  passed 
that  period  of  criticism,  however,  and  have  reverted 
to  the  idea  of  single  authorship  for  these  works,  and 
the  same  conclusion  has  been  generally  come  to  with 
regard  to  the  writings  attributed  to  Basil  Valentine. 
Other  biographic  details  contained  in  "  The  Tri- 
umphal Chariot  of  Antimony  "  are  undoubtedly 
more  correct.  According  to  them  Basil  Valentine 
travelled  in  England  and  Holland  on  missions  for  his 


376  OLD-TIME  MAKERS  OF  MEDICINE 

order,  and  went  through  France  and  Spain  on  a 
pilgrimage  to  St.  James  of  Compostella. 

Besides  this  work,  there  is  a  number  of  other 
books  of  Basil  Valentine's,  printed  during  the  first 
half  of  the  sixteenth  century,  that  are  well  known 
and  copies  of  which  may  be  found  in  most  of  the 
important  libraries.  The  United  States  Surgeon 
General's  Library  at  Washington  contains  not  a  few 
of  the  works  on  medical  subjects,  and  the  New  York 
Academy  of  Medicine  Library  has  some  valuable 
editions  of  certain  of  his  works.  Some  of  his  other 
well-known  books,  each  of  which  is  a  good-sized 
octavo  volume,  bear  the  following  descriptive  titles 
(I  give  them  in  English,  though  as  they  are  usually 
found,  they  are  in  Latin,  sixteenth-century  transla- 
tions of  the  original  German) :  "  The  World  in  Mini- 
ature :  or,  The  Mystery  of  the  World  and  of  Human 
Medical  Science,' '  published  at  Mayburg,  1609; 
"  The  Chemical  Apocalypse:  or,  The  Manifestation 
of  Artificial  Chemical  Compounds,"  published  in 
Erfurt  in  1624;  "  A  Chemico-Philosophic  Treatise 
Concerning  Things  Natural  and  Preternatural,  Es- 
pecially Eelating  to  the  Metals  and  the  Minerals," 
published  at  Frankfurt  in  1676;  "  Haliography:  or, 
The  Science  of  Salts :  A  Treatise  on  the  Preparation, 
Use,  and  Chemical  Properties  of  All  the  Mineral, 
Animal,  and  Vegetable  Salts,"  published  at  Bologna 
in  1644;  "  The  Twelve  Keys  of  Philosophy,"  Leipsic, 
1630.  These  are  of  interest  to  the  chemist  and 
physicist  rather  than  to  the  physician,  and  it  is  as 
a  Maker  of  Medicine  that  we  are  concerned  with 
Valentine  here. 

The  great  attention  aroused  in  Basil  Valentine's 


BASIL  VALENTINE  377 

work  at  the  Eenaissance  period  can  be  best  realized 
from  the  number  of  manuscript  copies  and  their 
wide  distribution.  His  books  were  not  all  printed 
at  one  place,  but,  on  the  contrary,  in  different  por- 
tions of  Europe.  The  original  edition  of  "  The 
Triumphal  Chariot  of  Antimony  "  was  published  in 
Leipsic  in  the  early  part  of  the  sixteenth  century. 
The  first  editions  of  the  other  books,  however,  ap- 
peared at  places  so  distant  from  Leipsic  as  Am- 
sterdam and  Bologna,  while  various  cities  of  Ger- 
many, as  Erfurt  and  Frankfurt,  claim  the  original 
editions  of  still  other  works.  Many  of  the  manu- 
script copies  still  exist  in  various  libraries  in  Eu- 
rope; and  while  there  is  no  doubt  that  some  unim- 
portant additions  to  the  supposed  works  of  Basil 
Valentine  have  come  from  the  attribution  to  him  of 
scientific  treatises  of  other  German  writers,  the  style 
and  the  method  of  the  principal  works  mentioned  is 
entirely  too  similar  not  to  have  been  the  fruit  of 
a  single  mind  and  that  possessed  of  a  distinct  in- 
vestigating genius,  setting  it  far  above  any  of  its 
contemporaries  in  scientific  speculation  and  observa- 
tion. 

The  most  interesting  feature  of  all  of  Basil  Valen- 
tine's writings  that  are  extant  is  the  distinctive  ten- 
dency to  make  his  observations  of  special  practical 
utility.  His  studies  in  antimony  were  made  mainly 
with  the  idea  of  showing  how  that  substance  might 
be  used  in  medicine.  He  did  not  neglect  to  point 
out  other  possible  uses,  however,  and  knew  the  secret 
of  the  employment  of  antimony  in  order  to  give 
sharpness  and  definition  to  the  impression  produced 
by  metal  types.    It  would  seem  as  though  he  was 


378  OLD-TIME  MAKERS  OF  MEDICINE 

the  first  scientist  who  discussed  this  subject,  and 
there  is  even  some  question  of  whether  printers  and 
typefounders  did  not  derive  their  ideas  in  this  mat- 
ter from  our  chemist. 

Interested  though  he  was  in  the  transmutation  of 
metals,  he  never  failed  to  try  to  find  and  suggest 
some  medicinal  use  for  all  of  the  substances  that 
he  investigated.  His  was  no  greedy  search  for  gold 
and  no  cumulation  of  investigations  with  the  idea 
of  benefiting  only  himself.  Mankind  was  always  in 
his  mind,  and  perhaps  there  is  no  better  demonstra- 
tion of  his  fulfilment  of  the  character  of  the  monk 
than  this  constant  solicitude  to  benefit  others  by 
every  bit  of  investigation  that  he  carried  out.  For 
him,  with  medieval  nobleness  of  spirit,  "  the  first 
part  of  every  work  must  be  the  invocation  of  God, 
and  the  last,  though  no  less  important  than  the 
first,  must  be  the  utility  and  fruit  for  mankind  that 
can  be  derived  from  it." 

The  career  of  the  last  of  the  Makers  of  Medicine 
in  the  Middle  Ages  may  be  summed  up  briefly  in 
a  few  sentences  that  show  how  thoroughly  this  old 
Benedictine  was  possessed  of  the  spirit  of  modern 
science.  He  believed  in  observation  as  the  most 
important  source  of  medical  knowledge.  He  valued 
clinical  experience  far  above  book  information.  He 
insisted  on  personal  acquaintanceship  on  the  part 
of  the  physician  with  the  drugs  he  used,  and  thought 
nothing  more  unworthy  of  a  practitioner  of  medicine, 
— indeed  he  sets  it  down  as  almost  criminal — than 
to  give  remedies  of  whose  composition  he  was  not 
well  aware  and  whose  effect  he  did  not  thoroughly 
understand.    He  thought  that  nature  was  the  most 


BASIL  VALENTINE  379 

important  aid  to  the  physician,  much  more  impor- 
tant than  drugs,  though  he  was  the  first  to  realize 
the  significance  of  chemical  affinities,  and  he  seems 
to  have  understood  rather  well  how  individual  often 
were  the  effects  obtained  from  drugs.  He  was  a 
patient  student,  a  faithful  observer,  a  writer  who 
did  not  begrudge  time  and  care  to  the  composition 
of  large  books  on  medicine,  yet  withal  he  was  no 
dry-as-dust  scholar,  but  eminently  human  in  his 
sympathies  with  ailing  humanity,  and  a  strenuous 
upholder  of  the  dignity  of  the  profession  to  which 
he  belonged.  Scarcely  more  can  be  said  of  anyone 
in  the  history  of  medicine,  at  least  so  far  as  good 
intentions  go ;  though  many  accomplished  more,  none 
deserve  more  honor  than  the  Thuringian  monk  whom 
we  know  as  Basil  Valentine. 

There  are  many  other  of  these  old-time  Makers  of 
Medicine  of  whom  nearly  the  same  thing  can  be  said. 
Basil  Valentine  is  only  one  of  a  number  of  men 
who  worked  faithfully  and  did  much  both  for  med- 
ical science  and  professional  life  during  the  thou- 
sand years  from  the  fall  of  Eome  to  the  fall  of 
Constantinople,  when,  according  to  what  used  to  be 
commonly  accepted  opinion,  men  were  not  animated 
by  the  spirit  of  research  and  of  fine  incentive  to 
do  good  to  men  that  we  are  so  likely  to  think  of 
as  belonging  exclusively  to  more  modern  times.  A 
man  whom  he  greatly  influenced,  Paracelsus,  took 
up  the  tradition  of  scientific  investigation  where 
Basil  Valentine  had  left  it.  His  work,  though  more 
successfully  revolutionary,  was  not  done  in  such  a 
fine  spirit  of  sympathy  with  humanity  nor  with  that 
simplicity  of  life  and  purity  of  intention  that  char- 


380  OLD-TIME  MAKERS  OF  MEDICINE 

acterized  the  old  monk's  work.  Paracelsus'  birth  in 
the  year  of  the  discovery  of  America  places  him 
among  the  makers  of  the  foundations  of  our  modern 
medicine,  and  he  will  be  treated  of  in  a  volume  on 
"  The  Forefathers  in  Medicine." 


APPENDIX  I 

ST.  LUKE  THE  PHYSICIAN 1 

In  the  midst  of  what  has  been  called  the  '  *  higher 
criticism  "  of  the  Bible  in  recent  times,  one  of  the 
long  accepted  traditions  that  has  been  most  strenu- 
ously assailed  and,  indeed,  in  the  minds  of  many 
scholars,  seemed,  for  a  time  at  least,  quite  discred- 
ited, was  that  St.  Luke  the  Evangelist,  the  author 
of  the  Third  Gospel  and  the  Acts  of  the  Apostles, 
was  a  physician.  Distinguished  authorities  in  early 
Christian  apologetics  have  declared  that  the  pillars 
of  primitive  Christian  history  are  the  genuine 
Epistles  of  St.  Paul,  the  writings  of  St.  Luke,  and 
the  history  of  Eusebius.  It  is  quite  easy  to  under- 
stand, then,  that  the  attack  upon  the  authenticity  of 
the  writings  usually  assigned  to  St.  Luke,  which  in 
many  minds  seemed  successful,  has  been  considered 
of  great  importance.  In  the  very  recent  time  there 
has  been  a  decided  reaction  in  this  matter.  This 
has  come,  not  so  much  from  Eoman  Catholics,  who 
have  always  clung  to  the  traditional  view,  and  whose 
great  Biblical  students  have  been  foremost  in  the 
support  of  the  previously  accepted  opinion,  but  from 
some  of  the  most  strenuous  of  the  German  higher 
critics,  who  now  appreciate  that  destructive,  so- 
called  higher  criticism  went  too  far,  and  that  the 
traditional  view  not  only  can  be  maintained,  but  is 
the  only  opinion  that  will  adequately  respond  to  all 
the  new  facts  that  have  been  found,  and  all  the  re- 
cently gathered  information  with  regard  to  the  re- 
lations of  events  in  the  olden  time. 

1  Paper  read  before  the  first  meeting  of  the  American  Guild  of  St. 
Luke. 

381 


382  OLD-TIME  MAKERS  OF  MEDICINE 

By  far  the  most  important  contribution  to  the  dis- 
cussion in  recent  years  came  not  long  since  from  the 
pen  of  Professor  Adolph  Harnack,  the  professor  of 
church  history  in  the  University  of  Berlin.  Pro- 
fessor Harnack's  name  is  usually  cited  as  that  of 
one  of  the  most  destructive  of  the  higher  critics. 
His  recent  book,  however,  "  Luke  the  Physician/'1  is 
an  entire  submission  to  the  old-fashioned  viewpoint 
that  the  writer  of  the  Third  Gospel  and  of  the  Acts 
of  the  Apostles  was  a  Greek  fellow-worker  of  St. 
Paul,  who  had  been  in  company  for  years  with 
Mark  and  Philip  and  James,  and  who  had  previ- 
ously been  a  physician,  and  was  evidently  well 
versed  in  all  the  medical  lore  of  that  time.  Har- 
nack does  not  merely  concede  the  old  position.  As 
might  be  expected,  his  rediscussion  of  the  subject 
clinches  the  arguments  for  the  traditional  view,  and 
makes  it  impossible  ever  to  call  it  in  question  again. 
It  is  easy  to  understand  how  important  are  such  ad- 
missions when  we  recall  how  much  this  traditional 
view  has  been  assailed,  and  how  those  who  have  held 
it  have  been  accused  of  old-fogyism  and  lack  of 
scholarship,  and  unwarranted  clinging  to  antiquated 
notions  just  because  they  thought  they  were  of  faith, 
and  how,  lacking  in  true  scholarship,  seriously  ham- 
pering genuine  investigation,  such  conservatism  has 
been  declared  to  be. 

The  question  of  Luke's  having  been  a  physician  is 
an  extremely  valuable  one,  and  no  one  in  our  time  is 
better  fitted  by  early  training  and  long  years  of 
study  to  elucidate  it  than  Professor  Harnack.  He  be- 
gan his  excursions  into  historical  writing  years  ago, 
as  I  understand,  as  an  historian  of  early  Christian 
medicine.  Some  of  his  works  on  medical  conditions 
just  before  and  after  Christ  are  quoted  confidently 
by  the  distinguished  German  medical  historians. 
From  this  department  he  graduated  into  the  field 

Published  by  Putnams,  New  York,  1909. 


APPENDIX  383 

of  the  higher  criticism.  He  is  eminently  in  a  posi- 
tion, therefore,  to  state  the  case  with  regard  to  St. 
Luke  fully,  and  to  indicate  absolutely  the  conclu- 
sions that  should  be  drawn  from  the  premises  of 
fact,  writings,  and  traditions  that  we  have.  He  does 
so  in  a  very  striking  way.  Perhaps  no  better  ex- 
ample of  his  thoroughly  lucid  and  eminently  logical 
mode  of  argumentation  is  to  be  found  than  the  para- 
graph in  which  he  states  the  question.  It  might  well 
be  recommended  as  an  example  of  terse  forcefulness 
and  logical  sequence  that  deserves  the  emulation  of 
all  those  who  want  to  write  on  medical  subjects.  If 
we  had  more  of  these  characteristic  qualities  of  Har- 
nack's  style,  our  medical  literature,  so  called,  would 
not  need  to  occupy  so  many  pages  of  print  as  it 
does — yet  would  say  more.    Here  it  is : 

St.  Luke,  according  to  St.  Paul,  was  a  physician.  When  a  physician 
writes  a  historical  work  it  does  not  necessarily  follow  that  his  profession 
shows  itself  in  his  writing;  yet  it  is  only  natural  for  one  to  look  for  traces 
of  the  author's  medical  profession  in  such  a  work.  These  traces  may  be 
of  different  kinds:  1,  The  whole  character  of  the  narrative  may  be  deter- 
mined by  points  of  view,  aims,  and  ideals  which  are  more  or  less  medical 
(disease  and  its  treatment);  2,  marked  preference  may  be  shown  for 
stories  concerning  the  healing  of  diseases,  which  stories  may  be  given  in 
great  number  and  detail;  3,  the  language  may  be  colored  by  the  lan- 
guage of  physicians  (medical  technical  terms,  metaphors  of  medical  char- 
acter, etc.).  All  these  three  groups  of  characteristic  signs  are  found,  as 
we  shall  see,  in  the  historical  work  which  bears  the  name  of  St.  Luke. 
Here,  however,  it  may  be  objected  that  the  subject  matter  itself  is 
responsible  for  these  traits,  so  that  their  evidence  is  not  decisive  for  the 
medical  calling  of  the  author.  Jesus  appeared  as  a  great  physician  and 
healer.  All  the  evangelists  say  this  of  Him;  hence  it  is  not  surprising 
that  one  of  them  has  set  this  phase  of  His  ministry  in  the  foreground,  and 
has  regarded  it  as  the  most  important.  Our  evangelist  need  not  there- 
fore have  been  a  physician,  especially  if  he  were  a  Greek,  seeing  that  in 
those  days  Greeks  with  religious  interests  were  disposed  to  regard 
religion  mainly  under  the  category  of  healing  and  salvation.  This  is 
true,  yet  such  a  combination  of  characteristic  signs  will  compel  us  to 
believe  that  the  author  was  a  physician  if,  4,  the  description  of  the  par- 
ticular cases  of  disease  shows  distinct  traces  of  medical  diagnosis  and 
scientific  knowledge;  5,  if  the  language,  even  where  questions  of  medi- 
cine or  of  healing  are  not  touched  upon,  is  colored  by  medical  phrase- 
ology; and,  6,  if  in  those  passages  where  the  author  speaks  as  an  eye- 
witness medical  traits  are  especially  and  prominently  apparent.  These 
three  kinds  of  tokens  are  also  found  in  the  historical  work  of  our 
author.  It  is  accordingly  proved  that  it  proceeds  from  the  pen  of  a 
physician. 


384  OLD-TIME  MAKERS  OF  MEDICINE 

The  importance  of  the  concession  that  Luke  was  a 
physician  should  be  properly  appreciated.  His 
whole  gospel  is  written  from  that  standpoint.  For 
him  the  Saviour  was  the  healer,  the  good  physician 
who  went  about  curing  the  ills  of  the  body,  while 
ministering  to  people's  souls.  He  has  more  ac- 
counts of  miracles  of  healing  than  any  of  the  other 
Evangelists.  He  has  taken  certain  of  the  stories 
of  the  other  Evangelists  who  were  eye-witnesses, 
and  when  they  were  told  in  naive  and  popular  lan- 
guage that  obscured  the  real  condition  that  was 
present,  he  has  retold  the  story  from  the  physician's 
standpoint,  and  thus  the  miracle  becomes  clearer 
than  ever.  In  one  case,  where  Mark  has  a  slur  on 
physicians,  Luke  eliminates  it.  In  a  number  of 
cases  the  correction  of  Mark's  popular  language  in 
the  description  of  ailments  is  made  in  terms  that 
could  not  have  been  used  except  by  one  thoroughly 
versed  in  the  Greek  medical  terminology  of  the 
times.  As  a  matter  of  fact,  there  seems  to  be  no 
doubt  now  that  Luke  had  been,  before  he  became  an 
Evangelist,  a  practising  physician  in  Malta  of  con- 
siderable experience.  His  testimony,  then,  to  the 
miracles  is  particularly  valuable  as  almost  a  medical 
eye-witness. 

In  medical  science,  St.  Luke's  time  was  by  no 
means  barren  of  knowledge.  The  Alexandrian 
school  of  medicine  had  done  some  fine  work  in  its 
time.  It  was  the  first  university  medical  school  in 
the  world's  history,  and  there  dissection  was  first 
practised  regularly  and  publicly  for  the  sake  of 
anatomy,  and  even  the  vivisection  of  criminals  who 
were  supplied  by  the  Ptolemei  for  human  physi- 
ology, was  a  part  of  the  school  curriculum.  A  num- 
ber of  important  discoveries  in  brain  anatomy  are 
attributed  to  Herophilus,  after  whom  the  torcular 
herophili  within  the  skull  is  named,  and  who  in- 
vented the  term  calamus  scriptorius  for  certain  ap- 


APPENDIX  385 

pearances  in  the  fourth  ventricle.  His  colleague, 
Erasistratus,  the  co-founder  of  this  school  at  Alex- 
andria, did  work  in  pathological  anatomy,  and  laid 
the  foundation  for  serious  study  there.  For  three 
centuries  there  is  some  good  worker,  at  or  in  con- 
nection with  Alexandria,  whose  name  is  preserved 
for  us  in  the  history  of  medicine.  Other  Greek 
schools  of  medicine  in  the  East,  as,  for  instance,  that 
of  Pergamos,  also  did  excellent  work.  Galen  is  the 
great  representative  of  this  school,  and  he  came  in 
the  century  after  St.  Luke.  A  physician  educated 
in  Greek  medicine  at  that  time,  then,  would  be  in 
an  excellent  position  to  judge  critically  of  the 
miracles  of  healing  of  the  Christ,  and  it  would  seem 
to  have  been  providential  that  Luke  was  called  for 
this  purpose. 

The  evidence  for  his  membership  of  our  pro- 
fession will  doubtless  be  interesting  to  all  physi- 
cians. Some  of  the  distinctive  passages  in  which 
Luke's  familiarity  with  medical  terms  to  such  an 
extent  that  to  express  his  meaning  he  found  him- 
self compelled  to  use  them,  will  appeal  at  once  to 
these,  for  whom  such  terms  are  part  of  everyday 
speech.  The  use  of  the  word  hydropikos,  which  is 
not  to  be  met  with  anywhere  else  in  the  New  Testa- 
ment, nor  in  the  non-medical  Greek  literature  of  that 
time,  though  the  word  is  of  frequent  occurrence  as  a 
designation  for  a  person  suffering  from  dropsy  (and 
always,  as  in  Luke,  the  adjective  for  the  substan- 
tive), in  Hippocrates,  Dioscorides,  and  Galen  is  a 
typical  example. 

Where  such  vague  terms  as  paralyzed  occur 
Luke  does  not  use  the  familiar  word,  but  the  med- 
ical term  that  meant  stricken  with  paralysis,  in- 
dicating not  any  inability  to  use  the  limbs,  but  such 
a  one  as  was  due  to  a  stroke  of  apoplexy.  We  who, 
as  physicians,  have  heard  of  so  many  cures  of 
paralysis  from  our  friends,  the  Eddyites,  are  prone 


386  OLD-TIME  MAKERS  OF  MEDICINE 

to  ask,  as  the  first  question,  what  sort  of  a  paralysis 
it  was.  Luke  made  inquiries  from  men  who  were 
eye-witnesses,  and  then  has  described  the  scene  with 
such  details  as  convinced  him  as  a  physician  of  the 
reality  of  the  miracle,  and  his  description  was  meant 
to  carry  conviction  to  the  minds  of  others. 

Occasionally  St.  Luke  uses  words  which  only  a 
physician  would  be  likely  to  know  at  all.  That  is 
to  say,  even  a  man  reasonably  familiar  with  medical 
terminology  and  medical  literature  would  not  be 
likely  to  know  them  unless  he  had  been  technically 
trained.  One  of  these  is  the  word  sphudron,  a  word 
which  is  only  medical,  and  is  not  to  be  found  even 
in  such  large  Greek  lexicons  of  ordinary  words  as 
that  of  Passow.  Sphudron  is  the  anatomical  term 
of  the  Grrseco -Alexandrian  school  for  the  condyles 
of  the  femur.  Gralen  and  other  medical  authors  use 
it,  and  Luke,  in  giving  the  details  of  the  story  of 
the  lame  man  cured,  in  the  third  chapter  of  the  Acts, 
seventh  verse,  selects  it  because  it  exactly  expresses 
the  meaning  he  wished  to  convey.  In  this  story 
there  are  a  number  of  added  medical  details.  These 
are  all  evidently  arranged  so  as  to  give  the  full 
medical  significance  to  the  miracle.  For  instance, 
the  man  had  been  lame  from  birth,  literally  from 
the  womb  of  his  mother.  At  this  time  he  was  forty 
years  of  age,  an  age  at  which  the  spontaneous  cure 
of  such  an  ailment  or,  indeed,  any  cure  of  it,  could 
scarcely  be  expected,  if,  during  the  preceding  time, 
there  had  been  no  improvement. 

In  the  story  of  the  cure  of  Saul's  blindness  Luke 
says  in  the  Acts  that  his  blindness  fell  from  him 
like  scales.  The  figure  is  a  typically  medical  one. 
The  word  for  fall  that  is  used  is,  as  was  pointed  out 
by  Hobart  ("  Medical  Language  of  St.  Luke,"  Dub- 
lin, 1882),  exactly  the  term  that  is  used  for  the  fall- 
ing of  scales  from  the  body.  The  term  for  scales  is 
the  specific  designation  of  the  particles  that  fall 


APPENDIX  387 

from  the  body  during  certain  skin  diseases  or  after 
certain  of  the  infectious  fevers,  as  in  scarlet  fever. 
Hippocrates  and  Galen  have  used  it  in  many  places. 
It  is  distinctively  a  medical  word.  In  the  story 
of  the  vision  of  St.  Peter,  told  also  in  the  Acts,  the 
word  ecstasis,  from  which  we  derive  our  word  ec- 
stasy, is  used.  This  is  the  only  word  St.  Luke  uses 
for  vision  and  he  alone  uses  it.  This  term  is  of 
constant  employment  in  a  technical  sense  in  the 
medical  writers  of  St.  Luke's  time  and  before  it. 
When  the  other  evangelists  talk  of  lame  people  they 
use  the  popular  term.  This  might  mean  anything 
or  nothing  for  a  physician.  Luke  uses  one  of  the 
terms  that  is  employed  by  physicians  when  they  wish 
to  indicate  that  for  some  definite  reason  there  is 
inability  to  walk. 

In  the  story  of  the  Good  Samaritan  there  are 
some  interesting  details  that  indicate  medical  inter- 
est on  the  part  of  the  writer.  It  is  Luke's  character- 
istic story  and  a  typical  medical  instance.  He  em- 
ploys certain  words  in  it  that  are  used  only  by 
medical  writers.  The  use  of  oil  and  wine  in  the 
treatment  of  the  wounds  of  the  stranger  traveller 
was  at  one  time  said  to  indicate  that  it  could  not 
have  been  a  physician  who  wrote  the  story,  since  the 
ancients  used  oil  for  external  applications  in  such 
cases  but  not  wine.  More  careful  search  of  the  old 
masters  of  medicine,  however,  has  shown  that  they 
used  oil  and  wine  not  only  internally  but  externally. 
Hippocrates,  for  instance,  has  a  number  of  recom- 
mendations of  this  combination  for  wounds.  It  is 
rather  interesting  to  realize  this,  and  especially  the 
wine  in  addition  to  the  oil,  because  wine  contains 
enough  alcohol  to  be  rather  satisfactorily  antiseptic. 
There  seems  no  doubt  that  wounds  that  had  been 
bathed  in  wine  and  then  had  oil  poured  over  them 
would  be  likely  to  do  better  than  those  which  were 
treated  in  other  ways.    The  wine  would  cleanse  and 


388  OLD-TIME  MAKERS  OF  MEDICINE 

at  least  inhibit  bacterial  growth.  The  subsequent 
covering  with  oil  would  serve  to  protect  the  wound 
to  some  degree  from  external  contamination. 

Sometimes  there  is  an  application  of  medical 
terms  to  something  extraneous  from  medicine  that 
makes  the  phrase  employed  quite  amusing.  For  in- 
stance, when  Luke  wants  to  explain  how  they 
strengthened  the  vessel  in  which  they  were  to  sail  he 
describes  the  process  by  the  term  which  was  used  in 
medical  Greek  to  mean  the  splinting  of  a  part  or  at 
least  the  binding  of  it  up  in  such  a  way  as  to  enable 
it  to  be  used.  The  word  was  quite  a  puzzle  to  the 
commentators  until  it  was  pointed  out  that  it  was 
the  familiar  medical  term,  and  then  it  was  easy  to 
understand.  Occasionally  this  use  of  a  medical 
term  gives  a  strikingly  accurate  significance  to 
Luke's  diction.  For  instance,  where  other  evangel- 
ists talk  of  the  Lord  looking  at  a  patient  or  turning 
to  them,  Luke  uses  the  expression  that  was  techni- 
cally employed  for  a  physician's  examination  of  his 
patient,  as  if  the  Lord  carefully  looked  over  the  ail- 
ing people  to  see  their  physical  needs,  and  then  pro- 
ceeded to  cure  them.  Manifestly  in  Luke's  mind  the 
most  interesting  phase  of  the  Lord's  life  was  His 
exhibition  of  curative  powers,  and  the  Saviour  was 
for  him  the  divine  healer,  the  God  physician  of  bodies 
as  well  as  of  souls. 

There  are  many  little  incidents  which  he  relates 
that  emphasize  this.  For  instance,  where  St.  Mark 
talks  about  the  healing  of  the  man  with  a 
withered  hand,  St.  Luke  adds  the  characteristic 
medical  note  that  it  was  the  right  hand.  When  he 
tells  of  the  cutting  off  of  the  ear  of  the  servant  of 
the  high  priest  in  the  Garden  of  Olives  St.  Luke  takes 
the  story  from  St.  Mark,  but  adds  the  information 
that  would  appeal  to  a  physician  th#t  it  was  the 
right  ear.  Moreover,  though  all  four  evangelists 
record  the  cutting  off  of  the  ear,  only  St,  Luke  adds 


APPENDIX  389 

the  information  that  the  Lord  healed  it  again.  It 
is  as  if  he  were  defending  the  kindly  feelings  of  the 
Divine  Physician  and  as  if  it  would  have  been  in- 
excusable had  He  not  exerted  His  miraculous  powers 
of  healing  on  this  occasion.  It  is  St.  Luke,  too,  who 
has  constantly  distinguished  between  natural  ill- 
nesses and  cases  of  possession.  This  careful  dis- 
tinction alone  would  point  to  the  author  of  the  third 
gospel  and  the  Acts  as  surely  a  physician.  As  it  is 
it  confirms  beyond  all  doubt  the  claim  that  the 
writer  of  these  portions  of  the  New  Testament  was 
a  physician  thoroughly  familiar  with  all  the  medical 
writings  of  the  time  and  probably  a  physician  who 
had  practised  for  a  long  time. 

Certain  miracles  of  healing  are  related  only  by 
St.  Luke  as  if  he  realized  better  than  any  of  the 
other  evangelists  the  evidential  value  that  such  in- 
stances would  have  for  future  generations  as  to  the 
divinity  of  the  personage  who  worked  them.  The 
beautiful  story  of  the  raising  from  death  of  the  son 
of  the  widow  of  Nain  is  probably  one  of  the  oftenest 
quoted  passages  from  St.  Luke.  It  is  a  charming 
bit  of  literature.  While  it  suggests  the  writer  physi- 
cian it  makes  one  almost  sure  that  the  other  tradition 
according  to  which  St.  Luke  was  also  a  painter  must 
be  true.  The  scene  is  as  picturesque  as  it  can  be. 
The  Lord  and  His  Apostles  and  the  multitudes  com- 
ing to  the  gate  of  the  little  city  just  as  in  the  evening 
sun  the  funeral  cortege  with  the  widow  burying  her 
only  son  came  out  of  it.  The  approach  of  the  Lord 
to  the  weeping  mother,  His  command  to  the  dead  son 
to  arise,  and  the  simple  words,  "  and  he  gave  him 
back  to  his  mother/ '  constitute  as  charming  a  scene 
as  a  painter  ever  tried  to  visualize.  Besides  this, 
Luke  alone  has  the  story  of  the  man  suffering  with 
dropsy  and  the  woman  sufYering  from  weakness. 
The  intensely  picturesque  quality  of  many  of  these 
scenes  that  he  describes  so  vividly  would  indeed  seem 


390  OLD-TIME  MAKERS  OF  MEDICINE 

to  place  beyond  all  doubt  the  old  tradition  that  he 
was  an  artist  as  well  as  a  physician. 

It  is  interesting  to  realize  that  it  is  to  Luke  alone 
that  we  owe  the  account  of  the  well-known  message 
sent  by  Christ  Himself  to  John  the  Baptist  when 
John  sent  his  disciples  to  inquire  as  to  His  mission. 
After  describing  His  ministry  He  said:  "  Go  and 
relate  to  John  what  you  have  heard  and  seen:  the 
blind  see,  the  lame  walk,  the  deaf  hear,  the  lepers 
are  made  clean,  the  dead  rise  again,  to  the  poor 
the  Gospel  is  preached.' '  To  no  one  more  than  to 
a  physician  would  that  description  of  His  mission 
appeal  as  surely  divine. 

To  those  who  care  to  follow  the  subject  still 
further,  and  above  all,  to  read  opinions  given  before 
the  reversal  of  the  verdict  of  the  higher  criticism 
on  the  Lucan  writings,  indeed  before  ever  that  trial 
was  brought,  there  is  much  in  "  Horse  Lucanae — A 
Biography  of  St.  Luke,"  by  Henry  Samuel  Baynes 
(Longmans,  1870),  that  will  surely  be  of  interest. 
He  has  some  interesting  quotations  which  show  how 
thoroughly  previous  centuries  realized  all  the  force 
of  modern  arguments.  For  instance,  the  following 
paragraph  from  Dr.  Nathaniel  Bobinson,  a  Scotch 
physician  of  the  eighteenth  century,  will  illustrate 
this.    Dr.  Bobinson  said: 

It  is  manifest  from  his  Gospel,  that  Luke  was  both  an  acute  ob- 
server, and  had  even  given  professional  attention  to  all  our  Saviour's 
miracles  of  healing.  Originally,  among  the  Egyptians,  divinity  and 
physic  were  united  in  the  same  order  of  men,  so  that  the  priest  had  the 
care  of  souls,  and  was  also  the  physician.  It  was  much  the  same  under 
the  Jewish  economy.  But  after  physic  came  to  be  studied  by  the 
Greeks,  they  separated  the  two  professions.  That  a  physician  should 
write  the  history  of  our  Saviour's  life  was  appropriate,  as  there  were 
divers  mysterious  things  to  be  noticed,  concerning  which  his  education 
enabled  him  to  form  a  becoming  judgment. 

It  is  even  interesting  to  realize  that  St.  Luke's 
tendency  to  use  medical  terms  has  been  of  definite 
value  in  determining  the  question  whether  both  the 


APPENDIX  391 

third  gospel  and  the  Acts  of  the  Apostles  are  by  the 
same  man.  They  have  been  attributed  to  St.  Luke 
traditionally,  but  in  the  higher  criticism  some  doubt 
has  been  thrown  on  this  and  an  elaborate  hypothe- 
sis of  dual  authorship  set  up.  It  has  been  asserted 
that  it  is  very  improbable  on  extrinsic  grounds  that 
they  were  both  written  by  one  hand  and  certain  in- 
trinsic evidence,  changes  in  the  mode  of  narration, 
especially  the  use  of  the  first  personal  pronoun  in 
the  plural  in  certain  passages,  has  been  pointed  to 
as  making  against  single  authorship.  This  tendency 
to  deny  old-time  traditions  of  authorship  with  re- 
gard to  many  classical  writings  was  a  marked  char- 
acteristic of  the  early  part  of  the  nineteenth  century, 
but  the  close  of  the  century  saw  practically  all  of 
these  denials  discredited.  The  nineteenth  century 
ushered  in  studies  of  Homer,  with  the  separatist 
school  perfectly  confident  in  their  assertion  that  the 
Iliad  and  the  Odyssey  were  not  by  the  same  person, 
and  even  that  the  Iliad  itself  was  the  work  of  several 
hands. 

At  the  beginning  of  the  twentieth  century  we  are 
quite  as  sure  that  both  the  Iliad  and  Odyssey  were 
written  by  the  same  person  and  that  the  separatists 
were  hurried  into  a  contrary  decision  not  a  little  by 
the  feeling  of  the  sensation  that  such  a  contradiction 
of  previously  accepted  ideas  would  create.  This  is 
a  determining  factor  in  many  a  supposed  novel  dis- 
covery, that  it  is  hard  always  to  discount  sufficiently. 
A  thing  may  be  right  even  though  it  is  old,  and  most 
new  discoveries,  it  must  not  be  forgotten,  that  is, 
most  of  those  announced  with  a  great  blare  of  trum- 
pets, do  not  maintain  themselves.  The  simple  argu- 
ment that  the  separatists  would  have  to  find  another 
poet  equal  to  Homer  to  write  the  other  poem  has 
done  more  than  anything  else  to  bring  their  opinion 
into  disrepute.  It  is  much  easier  to  explain  certain 
discrepancies,  differences  of  style,  and  of  treatment 


392  OLD-TIME  MAKEBS  OF  MEDICINE 

of  subjects,  as  well  as  other  minor  variants,  than  to 
supply  another  great  poet.  Most  of  the  works  of 
our  older  literatures  have  gone  through  a  similar 
trial  during  the  over-hasty  superficially  critical  nine- 
teenth century.  The  Nibelungenlied  has  been  at- 
tributed to  two  or  three  writers  instead  of  one.  The 
Cid,  the  national  epic  of  Spain,  and  the  Arthur 
Legends,  the  first  British  epic,  have  been  at  least 
supposed  to  be  amenable  to  the  same  sort  of  criti- 
cism. In  every  case,  scholars  have  gone  back  to 
the  older  traditional  view  of  a  single  author.  The 
phases  of  literary  and  historic  criticism  with  regard 
to  Luke's  writings  are,  then,  only  a  repetition  of 
what  all  our  great  national  classics  have  gone 
through  from  supercilious  scholarship  during  the 
past  hundred  years. 

It  is  not  surprising,  then,  that  there  should  be  dual 
or  even  triple  ascriptions  of  authorship  for  various 
portions  of  the  Scriptures,  and  Luke's  writings  have 
on  this  score  suffered  as  much  or  more  even  than 
others,  with  the  possible  exception  of  Moses.  It  is 
now  definitely  settled,  however,  that  the  similarities 
of  style  between  the  Acts  and  the  third  gospel  are 
too  great  for  them  to  have  come  from  two  different 
minds.  This  is  especially  true,  as  pointed  out  by 
Harnack,  in  all  that  regards  the  use  of  medical  terms. 
The  writer  of  the  Acts  and  the  writer  of  the  third 
gospel  knew  Greek  from  the  standpoint  of  the  phy- 
sician of  that  time.  Each  used  terms  that  we  find 
nowhere  else  in  Greek  literature  except  among  med- 
ical writers.  What  is  thus  true  for  one  critical  at- 
tack on  Luke's  reputation  is  also  true  in  another 
phase  of  recent  higher  criticism.  It  has  been  said 
that  certain  portions  of  the  Acts  which  are  called 
the  "  we  "  portions  because  the  narration  changes 
in  them  from  the  third  to  the  first  person  were  to 
be  attributed  to  another  writer  than  the  one  who 
wrote  the  narrative  portions.    Here,  once  more,  the 


APPENDIX  393 

test  of  the  medical  words  employed  has  decided  the 
case  for  Luke's  sole  authorship.  It  is  evidently  an 
excellent  thing  to  be  able  to  use  medical  terms  prop- 
erly if  one  wants  to  be  recognized  with  certainty 
later  on  in  history  for  just  what  one's  business  was. 
It  has  certainly  saved  the  situation  for  St.  Luke, 
though  there  may  be  some  doubt  as  to  the  real  force 
of  objections  thus  easily  overthrown. 

It  is  rather  interesting  to  realize  that  many  schol- 
ars of  the  present  generation  had  allowed  themselves 
to  be  led  away  by  the  German  higher  criticism  from 
the  old  tradition  with  regard  to  Luke  as  a  physician 
and  now  will  doubtless  be  led  back  to  former  views 
by  the  leader  of  German  biblical  critics.  It  shows 
how  much  more  distant  things  may  influence  certain 
people  than  those  nearer  home — how  the  hills  are 
green  far  away.  Harnack  confesses  that  the  best 
book  ever  written  on  the  subject  of  Luke  as  a  phy- 
sician, the  one  that  has  proved  of  most  value  to 
him,  and  that  he  still  recommends  everyone  to  read, 
was  originally  written  in  English.  It  is  Hobart's 
' '  Medical  Language  of  St.  Luke, ' ' x  written  more 
than  a  quarter  of  a  century  before  Harnack.  The 
Germans  generally  had  rather  despised  what  the 
English  were  doing  in  the  matter  of  biblical  criti- 
cism, and  above  all  in  philology.  Yet  now  the  ac- 
knowledged coryphaeus  of  them  all,  Harnack,  not  only 
admits  the  superiority  of  an  old-time  English  book, 
but  confesses  that  it  is  the  best  statement  of  the  sub- 
ject up  to  the  present  time,  including  his  own.  He 
constantly  quotes  from  it,  and  it  is  evident  that  it 
has  been  the  foundation  of  all  of  his  arguments.  It 
is  not  the  first  time  that  men  have  fetched  from 
afar  what  they  might  have  got  just  as  well  or  better 
at  home. 

Harnack  has  made  complete  the  demonstration, 

J  Dublin,  1882. 


394  OLD-TIME  MAKEBS  OF  MEDICINE 

then,  that  the  third  gospel  and  the  Acts  were  writ- 
ten by  St.  Luke,  who  had  been  a  practising  phy- 
sician. In  spite  of  this,  however,  he  finds  many  ob- 
jections to  the  Luke  narratives  and  considers  that 
they  add  very  little  that  is  valuable  to  the  contem- 
porary evidence  that  we  have  with  regard  to  Christ. 
He  impairs  with  one  hand  the  value  of  what  he  has 
so  lavishly  yielded  with  the  other.  He  finds  incon- 
sistencies and  discrepancies  in  the  narrative  that  for 
him  destroy  their  value  as  testimony.  A  lawyer 
would  probably  say  that  this  is  that  very  human  ele- 
ment in  the  writings  which  demonstrates  their  au- 
thenticity and  adds  to  their  value  as  evidence,  be- 
cause it  shows  clearly  the  lack  of  any  attempt  to  do 
anything  more  than  tell  a  direct  story  as  it  had 
come  to  the  narrator.  No  special  effort  was  made  to 
avoid  critical  objections  founded  on  details.  It  was 
the  general  impression  that  was  looked  for. 

Sir  William  Eamsay,  in  his  "  Luke  the  Phy- 
sician and  Other  Studies  in  the  History  of  Ee- 
ligion  "  (New  York:  Armstrong  and  Sons,  1908), 
has  answered  Harnack  from  the  side  of  the  profes- 
sional critic  with  much  force.  He  appreciates  thor- 
oughly the  value  of  Professor  Harnack's  book,  and 
above  all  the  reactionary  tendency  away  from  ni- 
hilistic so-called  higher  criticism  which  characterized 
so  much  of  German  writing  on  biblical  themes  in 
the  nineteenth  century.  He  says  (p.  7):  "  This 
[book  of  Harnack's]  alone  carries  Lukan  criticism 
a  long  step  forwards,  and  sets  it  on  a  new  and 
higher  plane.  Never  has  the  unity  and  character  of 
the  book  been  demonstrated  so  convincingly  and  con- 
clusively. The  step  is  made  and  the  plane  is  reached 
by  the  method  which  is  practised  in  other  depart- 
ments of  literary  criticism,  viz.,  by  dispassionate  in- 
vestigation of  the  work  and  by  discarding  fashion- 
able a  priori  theories." 

The  distinguished  English  traveller  and  writer 


APPENDIX  395 

on  biblical  subjects  points  out,  however,  that 
in  detail  many  of  Harnack's  objections  to  the 
Lukan  narratives  are  due  to  insufficient  considera- 
tion of  the  circumstances  in  which  they  were  written 
and  the  comparative  significance  of  the  details 
criticised.  He  says,  "  Harnack  lays  much  stress  on 
the  fact  that  inconsistencies  and  inexactnesses  occur 
all  through  Acts.  Some  of  these  are  undeniable; 
and  I  have  argued  that  they  are  to  be  regarded  in 
the  same  light  as  similar  phenomena  in  the  poem 
of  Lucretius  and  in  other  ancient  classical  writers, 
viz.,  as  proofs  that  the  work  never  received  the  final 
form  which  Luke  intended  to  give  it,  but  was  still 
incomplete  when  he  died.  The  evident  need  for  a 
third  book  to  complete  the  work,  together  with  those 
blemishes  in  expression,  form  the  proof.' ' 

Kamsay's  placing  of  Harnack 's  writing  in  general 
is  interesting  in  this  connection.  (P.  8)  "  Professor 
Harnack  stands  on  the  border  between  the  nineteenth 
and  twentieth  century.  His  book  shows  that  he  is  to 
a  certain  degree  sensitive  of  and  obedient  to  the  new 
spirit;  but  he  is  only  partially  so.  The  nineteenth 
century  critical  method  was  false,  and  is  already 
antiquated.  .  .  . 

' '  The  first  century  could  find  nothing  real  and  true 
that  was  not  accompanied  by  the  marvellous  and  the 
'  supernatural. '  The  nineteenth  century  could  find 
nothing  real  and  true  that  was.  Which  view  was 
right  and  which  was  wrong?  Was  either  complete? 
Of  these  two  questions,  the  second  alone  is  profitable 
at  the  present.  Both  views  were  right — in  a  certain 
way  of  contemplating;  both  views  were  wrong — in 
a  certain  way.  Neither  was  complete.  At  present, 
as  we  are  struggling  to  throw  off  the  fetters  which 
impeded  thought  in  the  nineteenth  century,  it  is 
most  important  to  free  ourselves  from  its  prejudices 
and  narrowness." 

He  adds  (pp.  26  and  27) :  "  There  are  clear  signs 


396  OLD-TIME  MAKERS  OF  MEDICINE 

of  the  unfinished  state  in  which  this  chapter  was  left 
by  Luke;  but  some  of  the  German  scholar's  criti- 
cisms show  that  he  has  not  a  right  idea  of  the  sim- 
plicity of  life  and  equipment  that  evidently  char- 
acterized the  jailer's  house  and  the  prison.  The 
details  which  he  blames  as  inexact  and  inconsistent 
are  sometimes  most  instructive  about  the  circum- 
stances of  this  provincial  town  and  Roman  colonia. 

' '  But  it  is  never  safe  to  lay  much  stress  on  small 
points  of  inexactness  or  inconsistency  in  any  author. 
One  finds  such  faults  even  in  the  works  of  modern 
scholarship  if  one  examines  them  in  the  microscopic 
fashion  in  which  Luke  is  studied  here.  I  think  I  can 
find  them  in  the  author  [Harnack]  himself.  His 
point  of  view  sometimes  varies  in  a  puzzling  way." 

As  a  matter  of  fact,  Harnack,  as  pointed  out  by 
Ramsay,  was  evidently  working  himself  more  and 
more  out  of  the  old  conclusion  as  to  the  lack  of  au- 
thenticity of  the  Lucan  writings  into  an  opinion 
ever  more  and  more  favorable  to  Luke.  For  instance, 
in  a  notice  of  his  own  book,  published  in  the  The- 
ologische  Literaturzeitung ,  "  he  speaks  far  more 
favorably  about  the  trustworthiness  and  credibility 
of  Luke,v  as  being  generally  in  a  position  to  acquire 
and  transmit  reliable  information,  and  as  having 
proved  himself  able  to  take  advantage  of  his  posi- 
tion. Harnack  was  gradually  working  his  way  to 
a  new  plane  of  thought.  His  later  opinion  is  more 
favorable. ' ' 

Ramsay  also  points  out  that  Professor  Giffert, 
one  of  our  American  biblical  critics,  had  felt  com- 
pelled by  the  geographical  and  historical  evidence 
to  abandon  in  part  the  older  unfavorable  criticism 
of  Luke  and  to  admit  that  the  Acts  is  more  trust- 
worthy than  previous  critics  allowed.  Above  all, 
"  he  saw  that  it  was  a  living  piece  of  literature 
written  by  one  author.' '  In  a  word,  Luke  is  being 
vindicated  in  every  regard. 


APPENDIX  397 

Some  of  the  supposed  inaccuracies  of  Luke  vanish 
when  careful  investigation  is  made.  Some  of  his 
natural  history  details,  for  instance,  have  been  im- 
pugned and  the  story  of  the  viper  that  * '  fastened  '  \ 
itself  upon  St.  Paul  in  Malta  has  been  cited  as  an 
example  of  a  story  that  would  not  have  been  told  in 
that  way  by  a  man  who  knew  medicine  and  the  re- 
lated sciences  in  Luke's  time.  Because  the  passage 
illustrates  a  number  of  phases  of  the  discussion  with 
regard  to  Luke's  language  I  make  a  rather  long 
quotation  from  Eamsay: 

Take  as  a  specimen  with  which  to  finish  off  this  paper  the  passage 
Acts  xxviii,  9  et  seq.,  which  is  very  fully  discussed  by  Harnack 
twice.  He  argues  that  the  true  meaning  of  the  passage  was  not 
understood  until  medical  language  was  compared,  when  it  was  shown 
that  the  Greek  word  by  which  the  act  of  the  viper  to  Paul's  hand  is 
described,  implies  "  bit "  and  not  merely  "  fastened  upon."  But  it  is 
a  well-assured  fact  that  the  viper,  a  poisonous  snake,  only  strikes, 
fixes  the  poison  fangs  on  the  flesh  for  a  moment,  and  withdraws  its 
head  instantly.  Its  action  could  never  be  what  is  attributed  by 
Luke  the  eye  witness  to  this  Maltese  viper;  that  it  hung  from  Paul's 
hand  and  was  shaken  off  into  the  fire  by  him.  On  the  other  hand, 
constrictors,  which  have  no  poison  fangs,  cling  in  the  way  described, 
but  as  a  rule  do  not  bite.  Are  we,  then,  to  understand  in  spite 
of  the  medical  style  and  the  authority  of  Professor  Blass  (who  trans- 
lates "  momordit "  in  his  edition ) ,  that  the  viper  fastened  upon  the 
apostle's  hand?  Then,  the  very  name  viper  is  a  difficulty.  Was 
Luke  mistaken  about  the  kind  of  snake  which  he  saw?  A  trained 
medical  man  in  ancient  times  was  usually  a  good  authority  about 
serpents,  to  which  great  respect  was  paid  in  ancient  medicine  and 
custom. 

Mere  verbal  study  is  here  utterly  at  fault.  We  can  make  no 
progress  without  turning  to  the  realities  and  facts  of  Maltese  natural 
history.  A  correspondent  obligingly  informed  me  some  years  ago 
that  Mr.  Bryan  Hook,  of  Farnham,  Surrey  (who,  my  correspondent 
assures  me,  is  a  thoroughly  good  naturalist),  had  found  in  Malta 
a  small  snake,  Coronella  austriaca,  which  is  rare  in  England,  but 
common  in  many  parts  of  Europe.  It  is  a  constrictor,  without 
poison  fangs,  which  would  cling  to  the  hand  or  arm  as  Luke  de- 
scribes. It  is  similar  in  size  to  the  viper,  and  so  like  in  markings 
and  general  appearance  that  Mr.  Hook,  when  he  caught  his  specimen, 
thought  he  was  killing  a  viper. 

My  friend,  Prof.  J.  W.  H.  Trail,  of  Aberdeen,  whom  I  consulted, 
replied  that  Coronella  Icevis  or  austriaca,  is  known  in  Sicily  and  the 
adjoining  islands;  but  he  can  find  no  evidence  of  its  existence  in 
Malta.  It  is  known  to  be  rather  irritable,  and  to  fix  its  small  teeth 
so  firmly  into  the  human  skin  as  to  need  a  little  force  to  pull  it  off, 


398  OLD-TIME  MAKERS  OF  MEDICINE 

though  the  teeth  are  too  short  to  do  any  real  injury  to  the  skin. 
Coronella  is  at  a  glance  very  much  like  a  viper;  and  in  the  flames 
it  would  not  be  closely  examined.  While  it  is  not  reported  as  found 
in  Malta  except  by  Mr.  Hook,  two  species  are  known  there  belong- 
ing to  the  same  family  and  having  similar  habits  {leopardinus  and 
zamenis  (or  coluber)  gemonensis) .  The  coloring  of  Coronella  leo- 
pardinus would  be  the  most  likely  to  suggest  a  viper. 

The  observations  justify  Luke  entirely.  We  have  here  a  snake  so 
closely  resembling  a  viper  as  to  be  taken  for  one  by  a  good  naturalist 
until  he  had  caught  and  examined  a  specimen.  It  clings,  and  yet  it 
also  bites  without  doing  harm.  That  the  Maltese  rustics  should  mis- 
take this  harmless  snake  for  a  venomous  one  is  not  strange.  Many  un- 
educated people  have  the  idea  that  all  snakes  are  poisonous  in  varying 
degrees,  just  as  the  vulgar  often  firmly  believe  that  toads  are  poison- 
ous. Every  detail  as  related  by  Luke  is  natural,  and  in  accordance 
with  the  facts  of  the  country. 

In  a  word,  then,  the  whole  question  as  to  Luke's 
authority  as  a  writer,  as  an  eye-witness  of  many 
things,  and  as  the  relator  of  many  others  with  regard 
to  which  he  had  obtained  the  testimony  of  eye-wit- 
nesses is  fully  vindicated.  Twenty  years  ago  many 
scholars  were  prone  to  doubt  this  whole  question. 
Ten  years  ago  most  of  them  were  convinced  that  the 
Luke  traditions  were  not  justified  by  recent  investi- 
gation. Now  we  have  come  back  once  more  to  the 
complete  acceptance  of  the  old  traditions. 

Perhaps  the  most  unfortunate  characteristic  of 
much  nineteenth-century  criticism  in  all  depart- 
ments, even  those  strictly  scientific,  was  the  marked 
tendency  to  reject  previous  opinions  for  new  ones. 
Somehow  men  felt  themselves  so  far  ahead  of  old- 
time  writers  and  thinkers  that  they  concluded  they 
must  hold  opinions  different  from  their  ancestors. 
In  nearly  every  case  the  new  ideas  that  they  evolved 
by  supposedly  newer  methods  are  not  standing  the 
test  of  time  and  further  study.  There  had  been  a 
continuous  belief  in  men's  minds,  having  its  basis 
very  probably  on  a  passage  in  one  of  St.  Peter's 
Epistles,  that  the  earth  would  dissolve  by  fire.  This 
was  openly  contradicted  all  during  the  nineteenth 
century  and  the  time  when  the  earth  would  freeze 
up    definitely    calculated    by    our    mathematicians. 


APPENDIX  399 

Now  after  having  studied  radioactivity  and  learned 
from  the  physicist  that  the  earth  is  heating  up  and 
will  eventually  get  too  hot  for  life,  we  calmly  go 
back  to  the  old  Petrine  declaration.  Some  of  the 
most  distinguished  of  the  German  biologists  of  the 
present  day,  such  men  as  Driesch  and  others,  calmly 
tell  us  that  the  edifice  erected  by  Darwin  will  have 
to  come  down  because  of  newly  discovered  evidence, 
and  indeed  some  of  them  go  so  far  as  to  declare  that 
Darwinism  was  a  crude  hypothesis  very  superficial 
in  its  philosophical  aspects  and  therefore  acceptable 
to  a  great  many  people  who,  because  it  was  easy  to 
understand  and  was  very  different  from  what  our 
fathers  had  believed,  hastened  to  accept  it.  Nothing 
shows  the  necessity  for  being  conservative  in  the 
matter  of  new  views  in  science  or  ethics  or  religion 
more  than  the  curious  transition  state  in  which  we 
are  with  regard  to  many  opinions  at  the  present 
time,  with  a  distinct  tendency  toward  reaction  to 
older  views  that  a  few  years  ago  were  thought  quite 
untenable.  We  are  rather  proud  of  the  advance  that 
we  are  supposed  to  be  making  along  many  lines  in 
science  and  scholarship,  and  yet  over  and  over  again, 
after  years  of  work,  we  prove  to  have  been  following 
a  wrong  lead  and  must  come  back  to  where  we 
started.  This  has  been  the  way  of  man  from  the  be- 
ginning and  doubtless  will  continue.  The  present 
generation  are  having  this  curious  regression  that 
follows  supposed  progress  strongly  emphasized  for 
them. 


APPENDIX  n 

SCIENCE  AT  THE  MEDIEVAL  UNIVEESI- 

TIES1 

With  the  growth  of  interest  in  science  and  in  na- 
ture study  in  our  own  day,  one  of  the  expressions 
that  is  probably  oftenest  heard  is  surprise  that  the 
men  of  preceding  generations  and  especially  uni- 
versity men  did  not  occupy  themselves  more  with 
the  world  around  them  and  with  the  phenomena  that 
are  so  tempting  to  curiosity.  Science  is  usually  sup- 
posed to  be  comparatively  new  and  nature  study  only 
a  few  generations  old.  Men  are  supposed  to  have 
been  so  much  interested  in  book  knowledge  and  in 
speculations  and  theories  of  many  kinds,  that  they 
neglected  the  realities  of  life  around  them  while  spin- 
ning fine  webs  of  theory.  Previous  generations,  of 
course,  have  indulged  in  theory,  but  then  our  own 
generation  is  not  entirely  free  from  that  amusing 
occupation.  Nothing  could  well  be  less  true,  however, 
than  that  the  men  of  preceding  generations  were  not 
interested  in  science  even  in  the  sense  of  physical 
science,  or  that  nature  study  is  new,  or  that  men 
were  not  curious  and  did  not  try  to  find  out  all  they 
could  about  the  phenomena  of  the  world  around 
them. 

The  medieval  universities  and  the  school-men  who 
taught  in  them  have  been  particularly  blamed  for 
their  failure  to  occupy  themselves  with  realities  in- 

1The  material  for  this  chapter  was  gathered  for  a  paper  read  before  the 
Medical  Improvement  Society  of  Boston  in  the  spring  of  1911.  In 
nearly  its  present  form  it  was  published  in  The  Popular  Science  Monthly 
for  May,  1911,  and  thanks  are  returned  to  the  editor  of  that  magazine 
for  permission  to  reprint  it  here.  The  additions  that  have  been  made 
refer  particularly  to  the  estimation  of  Aristotle  in  the  Middle  Ages. 

400 


APPENDIX  401 

stead  of  with  speculation.  We  are  coming  to  recog- 
nize their  wonderful  zeal  for  education,  the  large 
numbers  of  students  they  attracted,  the  enthusiasm 
of  their  students,  since  they  made  so  many  hand- 
written copies  of  the  books  of  their  masters,  the  de- 
votion of  the  teachers  themselves,  who  wrote  at 
much  greater  length  than  do  our  professors  even 
now  and  on  the  most  abstruse  subjects,  so  that  it  is 
all  the  more  surprising  to  think  they  should  have 
neglected  science.  The  thought  of  our  generation  in 
the  matter,  however,  is  founded  entirely  on  an  as- 
sumption. Those  who  know  anything  about  the 
writers  of  the  Middle  Ages  at  first  hand  are  not 
likely  to  think  of  them  as  neglectful  of  science  even 
in  our  sense  of  the  term.  Those  who  know  them 
at  second  hand  are,  however,  very  sure  in  the  matter. 
The  assumption  is  due  to  the  neglect  of  history 
that  came  in  the  seventeenth  and  eighteenth  cen- 
turies. We  have  many  other  similar  assumptions 
because  of  the  neglect  of  many  phases  of  mental  de- 
velopment and  applied  science  at  this  time.  For  in- 
stance, most  of  us  are  very  proud  of  our  modern 
hospital  development  and  think  of  this  as  a  great 
humanitarian  evolution  of  applied  medical  science. 
We  are  very  likely  to  think  that  this  is  the  first  time 
in  the  world's  history  that  the  building  of  hospitals 
has  been  brought  to  such  a  climax  of  development, 
and  that  the  houses  for  the  ailing  in  the  olden  time 
were  mere  refuges,  prone  to  become  death  traps  and 
at  most  makeshifts  for  the  solution  of  the  problem 
of  the  care  of  the  ailing  poor.  This  is  true  for  the 
hospitals  of  the  seventeenth  and  eighteenth  centuries, 
but  it  is  not  true  at  all  for  the  hospitals  of  the  thir- 
teenth and  fourteenth  and  fifteenth  centuries.  Miss 
Nutting  and  Miss  Dock  in  their  "  History  of  Nurs- 
ing ' ' x  have  called  attention  to  the  fact  that  the 
lowest  period  in  hospital  development  is  during  the 

1  New  York,  Putnam,  1908. 


402  OLD-TIME  MAKERS  OF  MEDICINE 

eighteenth  and  early  nineteenth  centuries.  Hospi- 
tals were  little  better  than  prisons,  they  had  narrow 
windows,  were  ill  provided  with  light  and  air  and 
hygienic  arrangements,  and  in  general  were  all  that 
we  should  imagine  old-time  hospitals  to  be.  The 
hospitals  of  the  earlier  time,  however,  had  fine  high 
ceilings,  large  windows,  abundant  light  and  air,  ex- 
cellent arrangements  for  the  privacy  of  patients,  and 
in  general  were  as  worthy  of  the  architects  of  the 
earlier  times  as  the  municipal  buildings,  the  cathe- 
drals, the  castles,  the  university  buildings,  and  every 
other  form  of  construction  that  the  late  medieval 
centuries  devoted  themselves  to. 

The  trouble  with  those  who  assume  that  there  was 
no  study  of  science  and  practically  no  attention  to 
nature  study  in  the  Middle  Ages  is  that  they  know 
nothing  at  all  at  first  hand  about  the  works  of  the 
men  who  wrote  in  the  medieval  period.  They  have 
accepted  declarations  with  regard  to  the  absolute  de- 
pendence of  the  scholastics  on  authority,  their  al- 
most divine  worship  of  Aristotle,  their  utter  readi- 
ness to  accept  authoritative  assertions  provided  they 
came  with  the  stamp  of  a  mighty  name,  and  then 
their  complete  lack  of  attention  to  observation  and 
above  all  to  experiment.  Nothing  could  well  be  more 
ridiculous  than  this  ignorant  assumption  of  knowl- 
edge with  regard  to  the  great  teachers  at  the  me- 
dieval universities.  Just  as  soon  as  there  is  definite 
knowledge  of  what  these  great  teachers  wrote  and 
taught,  not  only  does  the  previous  mood  of  blame  for 
them  for  not  paying  much  more  attention  to  science 
and  nature  at  once  disappear,  but  it  gives  place  to 
the  heartiest  admiration  for  the  work  of  these  great 
thinkers.  It  is  easy  to  appreciate,  then,  what  Pro- 
fessor Saintsbury  said  in  a  recent  volume  on  the 
thirteenth  century : 

And  there  have  even  been  in  these  latter  days  some  graceless  ones 
who  have  asked  whether  the  science  of  the  nineteenth  century  after  an 


APPENDIX  403 

equal  interval  will  be  of  any  more  positive  value — whether  it  will 
not  have  even  less  comparative  interest  than  that  which  appertains  to 
the  scholasticism  of  the  thirteenth. 

Three  men  were  the  great  teachers  in  the  medieval 
universities  at  their  prime.  They  have  been  read 
and  studied  with  interest  ever  since.  They  wrote 
huge  tomes,  but  men  have  pored  over  them  in  every 
generation.  They  were  Albertus  Magnus,  the 
teacher  of  the  other  two,  Thomas  Aquinas  and  Roger 
Bacon.  All  three  of  them  were  together  at  the  Uni- 
versity of  Paris  shortly  after  the  middle  of  the  thir- 
teenth century.  Anyone  who  wants  to  know  any- 
thing about  the  attitude  of  mind  of  the  medieval 
universities,  their  professors  and  students,  and  of  all 
the  intellectual  world  of  the  time  towards  science 
and  observation  and  experiment,  should  read  the 
books  of  these  men.  Any  other  mode  of  getting  at 
any  knowledge  of  the  real  significance  of  the  science 
of  this  time  is  mere  pretence.  These  constitute  the 
documents  behind  any  scientific  history  of  the  de- 
velopment of  science  at  this  time. 

It  is  extremely  interesting  to  see  the  attitude  of 
these  men  with  regard  to  authority.  In  Albert's 
tenth  book  (of  his  "  Summa  "),  in  which  he  cata- 
logues and  describes  all  the  trees,  plants,  and  herbs 
known  in  his  time,  he  observes :  ' '  All  that  is  here 
set  down  is  the  result  of  our  own  experience,  or  has 
been  borrowed  from  authors  whom  we  know  to  have 
written  what  their  personal  experience  has  con- 
firmed; for  in  these  matters  experience  alone  can 
be  of  certainty.' '  In  his  impressive  Latin  phrase 
"  experimentum  solum  certificat  in  talibus."  With 
regard  to  the  study  of  nature  in  general  he  was  quite 
as  emphatic.  He  was  a  theologian  as  well  as  a  sci- 
entist, yet  in  his  treatise  on  "  The  Heavens  and 
the  Earth  "  he  declared  that  "  in  studying  nature 
we  have  not  to  inquire  how  God  the  Creator  may,  as 
He  freely  wills,  use  His  creatures  to  work  miracles 


404  OLD-TIME  MAKERS  OF  MEDICINE 

and  thereby  show  forth  His  power.  We  have  rather 
to  inquire  what  nature  with  its  immanent  causes  can 
naturally  bring  to  pass."  * 

Just  as  striking  quotations  on  this  subject  might 
be  made  from  Eoger  Bacon.  Indeed,  Bacon  was 
quite  impatient  with  the  scholars  around  him  who 
talked  over-much,  did  not  observe  enough,  depended 
to  excess  on  authority,  and  in  general  did  as  mediocre 
scholars  always  do,  made  much  fuss  on  second-hand 
information — plus  some  filmy  speculations  of  their 
own.  Friar  Bacon,  however,  had  one  great  pupil 
whose  work  he  thoroughly  appreciated  because  it 
exhibited  the  opposite  qualities.  This  was  Petrus — 
we  have  come  to  know  him  as  Peregrinus — whose 
observations  on  magnetism  have  excited  so  much  at- 
tention in  recent  years  with  the  republications  of 
his  epistle  on  the  subject.  It  is  really  a  monograph 
on  magnetism  written  in  the  thirteenth  century. 
Eoger  Bacon's  opinion  of  it  and  of  its  author  fur- 
nishes us  the  best  possible  index  of  his  attitude  of 
mind  towards  observation  and  experiment  in  science. 

I  know  of  only  one  person  who  deserves  praise  for  his  work  in  ex- 
perimental philosophy  for  he  does  not  care  for  the  discourses  of  men 
and  their  wordy  warfare,  but  quietly  and  diligently  pursues  the  works 
of  wisdom.  Therefore  what  others  grope  after  blindly,  as  bats  in  the 
evening  twilight,  this  man  contemplates  in  their  brilliancy  because 
he  is  a  master  of  experiment.  Hence,  he  knows  all  of  natural  science 
whether  pertaining  to  medicine  and  alchemy,  or  to  matters  celestial 
or  terrestrial.  He  has  worked  diligently  in  the  smelting  of  ores 
as  also  in  the  working  of  minerals;  he  is  thoroughly  acquainted  with 
all  sorts  of  arms  and  implements  used  in  military  service  and  in 
hunting,  besides  which  he  is  skilled  in  agriculture  and  in  the  meas- 
urement of  lands.  It  is  impossible  to  write  a  useful  or  correct 
treatise  in  experimental  philosophy  without  mentioning  this  man's 
name.  Moreover,  he  pursues  knowledge  for  its  own  sake;  for  if  he 
wished  to  obtain  royal  favor,  he  could  easily  find  sovereigns  who 
would  honor  and  enrich  him. 

Similar  expressions  might  readily  be  quoted  from 
Thomas  Aquinas,  but  his  works  are  so  easy  to  secure 

1 "  De  Ccelo  et  Mundo,"  1,  tr,  iv.,  x. 


APPENDIX  405 

and  his  whole  attitude  of  mind  so  well  known,  that 
it  scarcely  seems  worth  while  taking  space  to  do  so. 
Aqninas  is  still  studied  very  faithfully  in  many  uni- 
versities, and  within  the  last  few  years  one  of  his 
great  text-books  of  philosophy  has  been  replaced  in 
the  curriculum  of  Oxford  University,  in  which  it 
occupied  a  prominent  position  in  the  long  ago,  as 
a  work  that  may  be  offered  for  examination  in  the 
department  of  philosophy.  It  is  with  regard  to  him 
particularly  that  there  has  been  the  greatest  revul- 
sion of  feeling  in  recent  years  and  a  recognition  of 
the  fact  that  here  was  a  great  thinker  familiar  with 
all  that  was  known  in  the  physical  sciences,  and  who 
had  this  knowledge  constantly  in  his  mind  when  he 
drew  his  conclusions  with  regard  to  philosophical  and 
theological  questions. 

It  used  to  be  the  fashion  to  make  little  of  the 
medieval  scholars  for  the  high  estimation  in  which 
they  held  Aristotle.  Occasionally  even  yet  one  hears 
narrowly  educated  men,  I  am  sorry  to  say  much 
more  frequently  scientific  specialists  than  others, 
talk  deprecatingly  of  this  ardent  devotion  to  Aris- 
totle. No  one  who  knows  anything  about  Aristotle 
ever  indulges  in  such  an  exhibition  of  ignorance  of 
the  realities  of  the  history  of  philosophy  and  science. 
To  know  Aristotle  well  is  to  think  of  him  as  proba- 
bly possessed  of  the  greatest  human  mind  that  ever 
existed.  We  do  not  need  to  go  back  to  the  Middle 
Ages  to  be  confirmed  in  that  opinion.  Modern  sci- 
entists who  know  their  science  well,  but  who  also 
know  Aristotle  well,  and  who  are  ardent  worship- 
pers at  his  shrine,  are  not  hard  to  find.  Romanes, 
the  great  English  biologist  of  the  end  of  the  nine- 
teenth century,  said:  "  It  appears  to  me  that  there 
can  be  no  question  that  Aristotle  stands  forth  not 
only  as  the  greatest  figure  in  antiquity  but  as  the 
greatest  intellect  that  has  ever  appeared  upon  this 
earth. ' ' 


406  OLD-TIME  MAKERS  OF  MEDICINE 

Before  Bomanes,  George  H.  Lewes,  in  his  inter- 
esting monograph  in  the  history  of  thought,  * '  Aris- 
totle, a  Chapter  in  the  History  of  Science,' '  is  quite 
as  complimentary  to  the  great  Greek  thinker.  We 
may  say  that  Lewes  was  by  no  means  partial  to 
Aristotle.  Anything  but  inclined  to  accept  author- 
ity as  of  value  in  philosophy,  he  had  been  rendered 
impatient  by  the  fact  that  so  much  of  the  history 
of  philosophy  was  dominated  by  Aristotle,  and  it 
was  only  that  the  panegyric  was  forced  from  him 
by  careful  study  of  all  that  the  Stagirite  wrote  that 
he  said :  ' '  History  gazed  on  him  with  wonder.  His 
intellect  was  piercing  and  comprehensive ;  his  attain- 
ments surpassed  those  of  every  philosopher;  his  in- 
fluence has  been  excelled  only  by  the  founders  of 
religion  .  .  .  his  vast  and  active  intelligence  for 
twenty  centuries  held  the  world  in  awe. ' ' 

Professor  Osborn,  whose  scholarly  study  of  the 
theory  of  evolution  down  the  ages  ' '  From  the  Greeks 
to  Darwin  "  rather  startled  the  world  of  science 
by  showing  not  only  how  old  was  a  theory  of  evolu- 
tion, but  how  frequently  it  had  been  stated  and  how 
many  of  them  anticipated  phases  of  our  own  thought 
in  the  matter,  pays  a  high  compliment  to  the  great 
Greek  scientist.  He  says:  "  Aristotle  clearly  states 
and  rejects  a  theory  of  the  origin  of  adaptive  struc- 
tures in  animals  altogether  similar  to  that  of  Dar- 
win.'?  He  then  quotes  certain  passages  from  Aris- 
totle's "  Physics,"  and  says:  "  These  passages 
seem  to  contain  absolute  evidence  that  Aristotle  had 
substantially  the  modern  conception  of  the  evolution 
of  life,  from  a  primordial,  soft  mass  of  living  matter 
to  the  most  perfect  forms,  and  that  even  in  these  he 
believed  that  evolution  was  incomplete  for  they 
were  progressing  to  higher  forms." 

Modern  French  scientists  are  particularly  lauda- 
tory in  their  estimation  of  Aristotle.  The  group 
of  biologists,  BufTon,  Cuvier,  St.  Hilaire,  and  others 


APPENDIX  407 

who  called  world  attention  to  French  science  and  its 
attainments  about  a  century  ago,  are  all  of  them  on 
record  in  highest  praise  of  Aristotle.  Cuvier  said: 
1  '  I  cannot  read  his  work  without  being  ravished  with 
astonishment.  It  is  impossible  to  conceive  how  a 
single  man  was  able  to  collect  and  compare  the  multi- 
tude of  facts  implied  in  the  rules  and  aphorisms  con- 
tained in  this  book.,, 

It  is  possible,  however,  to  get  opinions  ardently 
laudatory  of  Aristotle  from  the  serious  students  of 
any  nation,  provided  only  they  know  their  Aristotle. 
Sir  William  Hamilton,  the  Scotch  philosopher,  said : 

"  Aristotle's  seal  is  upon  all  the  sciences,  his  spec- 
ulations have  determined  those  of  all  subsequent 
thinkers.' '  Hegel,  the  German  philosophic  writer, 
is  not  less  outspoken  in  his  praise :  ' '  Aristotle  pene- 
trated the  whole  universe  of  things  and  subjected 
them  to  intelligence."  Kant,  who  is  often  said  to 
have  influenced  our  modern  thinking  more  than  any 
other  in  recent  generations,  has  his  compliment  for 
Aristotle.  It  relates  particularly  to  that  branch  of 
philosophy  with  which  Kant  had  most  occupied  him- 
self. The  Koenigsberg  philosopher  said:  "  Logic 
since  Aristotle,  like  Geometry  since  Euclid,  is  a  fin- 
ished science." 

I  do  not  want  to  tire  you  or  I  could  quote  many 
other  authorities  who  proclaim  Aristotle  the  genius 
of  the  race.  They  would  include  poets  like  Dante 
and  Goethe,  scholars  like  Cicero  and  Anthon,  literary 
men  like  Lessing  and  Eeich  and  many  others.  The 
scholars  of  the  Middle  Ages,  far  from  condemnation 
for  their  devotion  to  Aristotle,  deserve  the  highest 
praise  for  it.  If  they  had  done  nothing  else  but  ap- 
preciate Aristotle  as  our  greatest  modern  scholars 
have  done,  that  of  itself  would  proclaim  their  pro- 
found scholarship. 

The  medieval  writers  are  often  said  to  have  been 
uncritical  in  their  judgment,  but  in  their  lofty  esti- 


408  OLD-TIME  MAKERS  OF  MEDICINE 

mation  of  Aristotle  they  displayed  the  finest  possible 
critical  judgment.  On  the  contrary,  the  generations 
who  made  much  of  the  opportunity  to  minimize  me- 
dieval scholarship  because  of  its  worship  at  the 
shrine  of  Aristotle,  must  themselves  fall  under  the 
suspicion  at  least  of  either  not  knowing  Aristotle 
or  of  not  thinking  deeply  about  the  subjects  with 
regard  to  which  he  wrote.  For  in  all  the  world's  his- 
tory the  rule  has  been  that  whenever  men  have 
thought  deeply  about  a  subject  and  know  what  Aris- 
totle has  written  with  regard  to  that  subject,  they 
have  the  liveliest  admiration  for  the  great  Greek 
thinker.  This  is  true  for  philosophy,  logic,  meta- 
physics, politics,  ethics,  dramatics,  but  it  is  also 
quite  as  true  for  physical  science.  He  lacked  our 
knowledge,  though  not  nearly  to  the  degree  that  is 
usually  thought,  and  he  had  a  marvellous  accumula- 
tion of  information,  but  he  had  a  breadth  of  view 
and  a  thoroughness  of  appreciation  with  a  power 
of  penetration  that  make  his  opinions  worth  while 
knowing  even  on  scientific  subjects  in  our  enlight- 
ened age. 

As  for  the  supposed  swearing  by  Aristotle,  in  the 
sense  of  literally  accepting  his  opinions  without  dar- 
ing to  examine  them  critically,  which  is  so  constantly 
asserted  to  have  been  the  habit  of  the  medieval  schol- 
ars and  teachers,  it  is  extremely  difficult  in  the  light 
of  the  expressions  which  we  have  from  them,  to 
understand  how  this  false  impression  arose.  Aris- 
totle they  thoroughly  respected.  They  constantly 
referred  to  his  works,  but  so  has  every  thinking  gen- 
eration ever  since.  Whenever  he  had  made  a 
declaration  they  would  not  accept  the  contradiction 
of  it  without  a  good  reason,  but  whenever  they  had 
good  reasons,  Aristotle's  opinion  was  at  once  re- 
jected without  compunction.  Albertus  Magnus,  for 
instance,  said :  ' '  Whoever  believes  that  Aristotle 
was  a  God  must  also  believe  that  he  never  erred, 


APPENDIX  409 

but  if  we  believe  that  Aristotle  was  a  man,  then 
doubtless  he  was  liable  to  err  just  as  we  are."  A 
number  of  direct  contradictions  of  Aristotle  we  have 
from  Albert.  A  well-known  one  is  that  with  regard 
to  Aristotle's  assertion  that  lunar  rainbows  ap- 
peared only  twice  in  fifty  years.  Albert  declared 
that  he  himself  had  seen  two  in  a  single  year. 

Indeed,  it  seems  very  clear  that  the  whole  trend 
of  thought  among  the  great  teachers  of  the  time  was 
away  from  the  acceptance  of  scientific  conclusions 
on  authority  unless  there  was  good  evidence  for 
them  available.  They  were  quite  as  impatient  as  the 
scientists  of  our  time  with  the  constant  putting  for- 
ward of  Aristotle  as  if  that  settled  a  scientific  ques- 
tion. Eoger  Bacon  wanted  the  Pope  to  forbid  the 
study  of  Aristotle  because  his  works  were  leading 
men  astray  from  the  study  of  science,  his  authority 
being  looked  upon  as  so  great  that  men  did  not  think 
for  themselves  but  accepted  his  assertions.  Smaller 
men  are  always  prone  to  do  this,  and  indeed  it  con- 
stitutes one  of  the  difficulties  in  the  way  of  advance 
in  scientific  knowledge  at  all  times,  as  Eoger  Bacon 
himself  pointed  out. 

These  are  the  sort  of  expressions  that  are  to  be 
expected  from  Friar  Bacon  from  what  we  know  of 
other  parts  of  his  work.  His  "  Opus  Tertium  "  was 
written  at  the  request  of  Pope  Clement  IV,  because 
the  Pope  had  heard  many  interesting  accounts  of 
what  the  great  thirteenth-century  teacher  and  experi- 
menter was  doing  at  the  University  of  Oxford,  and 
wished  to  learn  for  himself  the  details  of  his  work. 
Bacon  starts  out  with  the  principle  that  there  are 
four  grounds  of  human  ignorance.  These  are, ' '  first, 
trust  in  inadequate  authority;  second,  that  force  of 
custom  which  leads  men  to  accept  without  properly 
questioning  what  has  been  accepted  before  their 
time;  third,  the  placing  of  confidence  in  the  asser- 
tions of  the  inexperienced;  and  fourth,  the  hiding  of 


410  OLD-TIME  MAKEBS  OF  MEDICINE 

one 's  own  ignorance  behind  the  parade  of  superficial 
knowledge,  so  that  we  are  afraid  to  say  I  do  not 
know."  Professor  Henry  Morley,  a  careful  student 
of  Bacon's  writings,  said  with  regard  to  these  ex- 
pressions of  Bacon: 

No  part  of  that  ground  has  yet  been  cut  away  from  beneath  the  feet 
of  students,  although  six  centuries  have  passed.  We  still  make  sheep- 
walks  of  second,  third  and  fourth,  and  fiftieth  hand  references  to 
authority;  still  we  are  the  slaves  of  habit,  still  we  are  found  fol- 
lowing too  frequently  the  untaught  crowd,  still  we  flinch  from  the 
righteous  and  wholesome  phrase  "  I  do  not  know "  and  acquiesce 
actively  in  the  opinion  of  others  that  we  know  what  we  appear  to 
know. 

In  his  * '  Opus  Ma  jus  ' '  Bacon  had  previously  given 
abundant  evidence  of  his  respect  for  the  experi- 
mental method.  There  is  a  section  of  this  work 
which  bears  the  title  "  Scientia  Experimentalis. ' ' 
In  this  Bacon  affirms  that  "without  experiment 
nothing  can  be  adequately  known.  An  argument  may 
prove  the  correctness  of  a  theory,  but  does  not  give 
the  certitude  necessary  to  remove  all  doubt,  nor  will 
the  mind  repose  in  the  clear  view  of  truth  unless  it 
finds  its  way  by  means  of  experiment. ' '  To  this  he 
later  added  in  his  ' '  Opus  Tertium  ' ' :  "  The  strong- 
est argument  proves  nothing  so  long  as  the  conclu- 
sions are  not  verified  by  experience.  Experimental 
science  is  the  queen  of  sciences,  and  the  goal  of  all 
speculation. ' r 

It  is  no  wonder  that  Dr.  Whewell,  in  his  ' '  History 
of  the  Inductive  Sciences,' '  should  have  been  un- 
stinted in  his  praise  of  Eoger  Bacon's  work  and 
writings.  In  a  well-known  passage  he  says  of  the 
"  Opus  Majus  ": 

Roger  Bacon's  "Opus  Majus"  is  the  encyclopedia  and  "Novum 
Organon"  of  the  thirteenth  century,  a  work  equally  wonderful  with 
regard  to  its  wonderful  scheme  and  to  the  special  treatises  by 
which  the  outlines  of  the  plans  are  filled  up.  The  professed  object 
of  the  work  is  to  urge  the  necessity  of  a  reform  in  the  mode  of 
philosophizing,  to  set  forth  the  reasons  why  knowledge  had  not  made 
greater  progress,  to  draw  back  attention  to  the  sources  of  knowl- 


APPENDIX  411 

edge  which  had  been  unwisely  neglected,  to  discover  other  sources 
which  were  yet  almost  untouched,  and  to  animate  men  in  the 
undertaking  of  a  prospect  of  the  vast  advantages  which  it  offered. 
In  the  development  of  this  plan  all  the  leading  portions  of  science 
are  expanded  in  the  most  complete  shape  which  they  had  at  that 
time  assumed;  and  improvements  of  a  very  wide  and  striking  kind 
are  proposed  in  some  of  the  principal  branches  of  study.  Even  if  the 
work  had  no  leading  purposes  it  would  have  been  highly  valuable  a3 
a  treasure  of  the  most  solid  knowledge  and  soundest  speculations 
of  the  time;  even  if  it  had  contained  no  such  details  it  would  have 
been  a  work  most  remarkable  for  its  general  views  and  scope. 

As  a  matter  of  fact  the  universities  of  the  Middle 
Ages,  far  from  neglecting  science,  were  really  scien- 
tific universities.  Because  the  universities  of  the 
early  nineteenth  century  occupied  themselves  almost 
exclusively  with  languages  and  especially  formed 
students '  minds  by  means  of  classical  studies,  men  in 
our  time  seem  to  be  prone  to  think  that  such  lin- 
guistic studies  formed  the  main  portion  of  the  cur- 
riculum of  the  universities  in  all  the  old  times  and 
particularly  in  the  Middle  Ages.  The  study  of  the 
classic  languages,  however,  came  into  university  life 
only  after  the  Renaissance.  Before  that  the  under- 
graduates of  the  universities  had  occupied  them- 
selves almost  entirely  with  science.  It  was  quite  as 
much  trouble  to  introduce  linguistic  studies  into  the 
old  universities  in  the  Renaissance  time  to  replace 
science,  as  it  was  to  secure  room  for  science  by  push- 
ing out  the  classics  in  the  modern  time.  Indeed  the 
two  revolutions  in  education  are  strikingly  similar 
when  studied  in  detail.  Men  who  had  been  brought 
up  on  science  before  the  Renaissance  were  quite  sure 
that  that  formed  the  best  possible  means  of  develop- 
ing the  mind.  In  the  early  nineteenth  century  men 
who  had  been  formed  on  the  classics  were  quite  as 
sure  that  science  could  not  replace  them  with  any 
success. 

There  is  no  pretence  that  this  view  of  the  medieval 
universities  is  a  new  idea  in  the  history  of  educa- 
tion.   Those  who  have  known  the  old  universities  at 


412  OLD-TIME  MAKERS  OF  MEDICINE 

first  hand  by  the  study  of  the  actual  books  of  their 
professors  and  by  familiarity  with  their  courses  of 
study,  have  not  been  inclined  to  make  the  mistake 
of  thinking  that  the  medieval  university  neglected 
science.  Professor  Huxley  in  his  "  Inaugural  Ad- 
dress as  Eector  of  Aberdeen  University  "  some 
thirty  years  ago  stated  very  definitely  his  recognition 
of  medieval  devotion  to  science.  His  words  are  well 
worth  remembering  by  all  those  who  are  accustomed 
to  think  of  our  time  as  the  first  in  which  the  study 
of  science  was  taken  up  seriously  in  our  universities. 
Professor  Huxley  said : 

The  scholars  of  the  medieval  universities  seem  to  have  studied 
grammar,  logic,  and  rhetoric;  arithmetic  and  geometry;  astronomy, 
theology,  and  music.  Thus  their  work,  however  imperfect  and  faulty, 
judged  by  modern  lights,  it  may  have  been,  brought  them  face  to 
face  with  all  the  leading  aspects  of  the  many-sided  mind  of  man. 
For  these  studies  did  really  contain,  at  any  rate  in  embryo,  some- 
times it  may  be  in  caricature,  what  we  now  call  philosophy,  mathe- 
matical and  physical  science,  and  art.  And  I  doubt  if  the  curriculum 
of  any  modern  university  shows  so  clear  and  generous  a  comprehen- 
sion of  what  is  meant  by  culture,  as  this  old  Trivium  and  Quadrivium 
does. 

It  would  be  entirely  a  mistake,  however,  to  think 
that  these  great  writers  and  teachers  who  influenced 
the  medieval  universities  so  deeply  and  whose  works 
were  the  text-books  of  the  universities  for  centuries 
after,  only  had  the  principles  of  physical  and  ex- 
perimental science  and  did  not  practically  apply 
them.  As  a  matter  of  fact  their  works  are  full  of 
observation.  Once  more,  the  presumption  that  they 
wrote  only  nonsense  with  regard  to  science  comes 
from  those  who  do  not  know  their  writings  at  all, 
while  great  scientists  who  have  taken  the  pains  to 
study  their  works  are  enthusiastic  in  praise.  Hum- 
boldt, for  instance,  says  of  Albertus  Magnus,  after 
reading  some  of  his  works  with  care: 

Albertus  Magnus  is  equally  active  and  influential  in  promoting  the 
study  of  natural  science  and  of  the  Aristotelian  philosophy.  His 
works  contain  some  exceedingly  acute  remarks  on  the  organic  struc- 


APPENDIX  413 

ture  and  physiology  of  plants.  One  of  his  works  bearing  the  title  of 
"  Liber  Cosmographicus  De  Natura  Locorum  "  is  a  species  of  physical 
geography.  I  have  found  in  it  considerations  on  the  dependence  of 
temperature  concurrently  on  latitude  and  elevation  and  on  the  effect 
of  different  angles  of  the  sun's  rays  in  heating  the  ground  which  have 
excited  my  surprise. 

It  is  with  regard  to  physical  geography  of 
course  that  Humboldt  is  himself  a  distinguished 
authority. 

Humboldt's  expression  that  he  found  some  exceed- 
ingly acute  remarks  on  the  organic  structure  and 
physiology  of  plants  in  Albert  the  Great's  writings 
will  prove  a  great  surprise  to  many  people.  Meyer, 
the  German  historian  of  botany,  however,  has 
re-echoed  Humboldt's  praise  with  emphasis.  The 
extraordinary  erudition  and  originality  of  Albert's 
treatise  on  plants  drew  from  Meyer  the  comment : 

No  botanist  who  lived  before  Albert  can  be  compared  with  him 
unless  Theophrastus,  with  whom  he  was  not  acquainted;  and  after 
him  none  has  painted  nature  in  such  living  colors  or  studied  it  so 
profoundly  until  the  time  of  Conrad  Gessner  and  Csesalpino. 

These  men,  it  may  be  remarked,  come  three  cen- 
turies after  Albert's  time.  A  ready  idea  of  Albert's 
contributions  to  physical  science  can  be  obtained 
from  his  life  by  Sighart,  which  has  been  translated 
into  English  by  Dixon  and  was  published  in  London 
in  1870.  Pagel,  in  Puschmann's  "  History  of  Medi- 
cine," already  referred  to,  gives  a  list  of  the  books 
written  by  Albert  on  scientific  matters  with  some 
comments  which  are  eminently  suggestive,  and  fur- 
nish solid  basis  for  the  remark  that  I  have  made, 
that  men's  minds  were  occupied  with  nearly  the  same 
problems  in  science  in  the  thirteenth  century  as  we 
are  now,  while  the  conclusions  they  came  to  were 
not  very  different  from  ours,  though  reached  so  long 
before  us. 

This  catalogue  of  Albertus  Magnus '  works  shows 
very  well  his  own  interest  and  that  of  his  generation 
in  physical  science  of  all  kinds.    There  were  eight 


414  OLD-TIME  MAEEES  OF  MEDICINE 

treatises  on  Aristotle's  physics  and  on  the  under- 
lying principles  of  natural  philosophy  and  of  energy 
and  of  movement;  four  treatises  concerning  the 
heavens  and  the  earth,  one  on  physical  geography 
which  also  contains,  according  to  Pagel,  numerous 
suggestions  on  ethnography  and  physiology.  There 
are  two  treatises  on  generation  and  corruption,  six 
books  on  meteors,  five  books  on  minerals,  three  books 
on  the  soul,  two  bo©ks  on  the  intellect,  a  treatise  on 
nutritives,  and  then  a  treatise  on  the  senses  and  an- 
other on  the  memory  and  on  the  imagination.  All 
the  phases  of  the  biological  sciences  were  especially 
favorite  subjects  of  his  study.  There  is  a  treatise  on 
the  motion  of  animals,  a  treatise  in  six  books  on 
vegetables  and  plants,  a  treatise  on  breathing  things, 
a  treatise  on  sleep  and  waking,  a  treatise  on  youth 
and  old  age,  and  a  treatise  on  life  and  death.  His 
treatise  on  minerals  contains,  according  to  Pagel,  a 
description  of  ninety-five  different  kinds  of  precious 
stones.  Albert's  volumes  on  plants  were  reproduced 
with  Meyer,  the  German  botanist,  as  editor  (Berlin, 
1867) .  All  of  Albert's  books  are  available  in  modern 
editions. 
Pagel  says  of  Albertus  that 

His  profound  scholarship,  his  boundless  industry,  the  almost  incon- 
trollable  impulse  of  his  mind  after  universality  of  knowledge,  the 
many-sidedness  of  his  literary  productivity,  and  finally  the  almost 
universal  recognition  which  he  received  from  his  contemporaries  and 
succeeding  generations,  stamp  him  as  one  of  the  most  imposing  char- 
acters and  one  of  the  most  wonderful  phenomena  of  the  Middle  Ages. 

In  another  passage  Pagel  has  said : 

While  Albert  was  a  Churchman  and  an  ardent  devotee  of  Aristotle, 
in  matters  of  natural  phenomena  he  was  relatively  unprejudiced  and 
presented  an  open  mind.  He  thought  that  he  must  follow  Hippocrates 
and  Galen,  rather  than  Aristotle  and  Augustine,  in  medicine  and  in 
the  natural  sciences.  We  must  concede  it  a  special  subject  of  praise 
for  Albert  that  he  distinguished  very  strictly  between  natural  and 
supernatural  phenomena.  The  former  he  considered  as  entirely  the 
object  of  the  investigation  of  nature.  The  latter  he  handed  over 
to  the  realm  of  metaphysics. 


APPENDIX  415 

Eoger  Bacon  is,  however,  the  one  of  these  three 
great  teachers  who  shows  us  how  thoroughly  prac- 
tical was  the  scientific  knowledge  of  the  universities 
and  how  much  it  led  to  important  useful  discoveries 
in  applied  science  and  to  anticipations  of  what  is 
most  novel  even  in  our  present-day  sciences.  Some 
of  these  indeed  are  so  startling,  that  only  that  we 
know  them  not  by  tradition  but  from  his  works, 
where  they  may  be  readily  found  without  any  doubt 
of  their  authenticity,  we  should  be  sure  to  think  that 
they  must  be  the  result  of  later  commentators '  ideas. 
Bacon  was  very  much  interested  in  astronomy,  and 
not  only  suggested  the  correction  of  the  calendar,  but 
also  a  method  by  which  it  could  be  kept  from  wander- 
ing away  from  the  actual  date  thereafter.  He  dis- 
covered many  of  the  properties  of  lenses  and  is  said 
to  have  invented  spectacles  and  announced  very  em- 
phatically that  light  did  not  travel  instantaneously 
but  moved  with  a  definite  velocity.  He  is  sometimes 
said  to  have  invented  gunpowder,  but  of  course  he 
did  not,  though  he  studied  this  substance  in  various 
forms  very  carefully  and  drew  a  number  of  conclu- 
sions in  his  observations.  He  was  sure  that  some 
time  or  other  man  would  learn  to  control  the  energies 
exhibited  by  explosives  and  that  then  he  would  be 
able  to  accomplish  many  things  that  seemed  quite 
impossible  under  present  conditions. 

He  said,  for  instance : 

Art  can  construct  instruments  of  navigation,  such  that  the  largest 
vessels  governed  by  a  single  man  will  traverse  rivers  and  seas  more 
rapidly  than  if  they  were  filled  with  oarsmen.  One  may  also  make 
carriages  which  without  the  aid  of  any  animal  will  run  with  re- 
markable swiftness. 

In  these  days  when  the  automobile  is  with  us  and 
when  the  principal  source  of  energy  for  motor  pur- 
poses is  derived  from  explosives  of  various  kinds, 
this    expression    of    Roger    Bacon    represents    a 


416  OLD-TIME  MAKERS  OF  MEDICINE 

prophecy  marvellously  surprising  in  its  fulfilment. 
It  is  no  wonder  that  the  book  whence  it  comes  bears 
the  title  "  De  Secretis  Artis  et  Naturae.' '  Eoger 
Bacon  even  went  to  the  extent,  however,  of  declaring 
that  man  would  some  time  be  able  to  fly.  He  was 
even  sure  that  with  sufficient  pains  he  could  himself 
construct  a  flying  machine.  He  did  not  expect  to 
use  explosives  for  his  motor  power,  however,  but 
thought  that  a  windlass  properly  arranged,  worked 
by  hand,  might  enable  a  man  to  make  sufficient  move- 
ment to  carry  himself  aloft  or  at  least  to  support 
himself  in  the  air,  if  there  were  enough  surface  to 
enable  him  to  use  his  lifting  power  to  advantage. 
He  was  in  intimate  relations  by  letter  with  many 
other  distinguished  inventors  and  investigators  be- 
sides Peregrinus  and  was  a  source  of  incentive  and 
encouragement  to  them  all. 

The  more  one  knows  of  Aquinas  the  more  surprise 
there  is  at  his  anticipation  of  many  modern  scientific 
ideas.  At  the  conclusion  of  a  course  on  cosmology 
delivered  at  the  University  of  Paris  he  said  that 
"  nothing  at  all  would  ever  be  reduced  to  nothing- 
ness "  (nihil  omnino  in  nihilum  redigetur).  He  was 
teaching  the  doctrine  that  man  could  not  destroy 
matter  and  God  would  not  annihilate  it.  In  other 
words,  he  was  teaching  the  indestructibility  of  mat- 
ter even  more  emphatically  than  we  do.  He  saw 
the  many  changes  that  take  place  in  material  sub- 
stances around  us,  but  he  taught  that  these  were  only 
changes  of  form  and  not  substantial  changes  and 
that  the  same  amount  of  matter  always  remained  in 
the  world.  At  the  same  time  he  was  teaching  that 
the  forms  in  matter  by  which  he  meant  the  combina- 
tions of  energies  which  distinguish  the  various  kinds 
of  matter  are  not  destroyed.  In  other  words,  he 
was  anticipating  not  vaguely,  but  very  clearly  and 
definitely,  the  conservation  of  energy.  His  teaching 
with  regard  to  the  composition  of  matter  was  very 


APPENDIX  417 

like  that  now  held  by  physicists.  He  declared  that 
matter  was  composed  of  two  principles,  prime  mat- 
ter and  form.  By  forma  he  meant  the  dynamic  ele- 
ment in  matter,  while  by  materia  prima  he  meant  the 
underlying  substratum  of  material,  the  same  in  every 
substance,  but  differentiated  by  the  dynamics  of 
matter. 

It  used  to  be  the  custom  to  make  fun  of  these  me- 
dieval scientists  for  believing  in  the  transmutation 
of  metals.  It  may  be  said  that  all  three  of  these 
greatest  teachers  did  not  hold  the  doctrine  of  the 
transmutation  of  metals  in  the  exaggerated  way  in 
which  it  appealed  to  many  of  their  contemporaries. 
The  theory  of  matter  and  form,  however,  gave  a 
philosophical  basis  for  the  idea  that  one  kind  of 
matter  might  be  changed  into  another.  We  no  longer 
think  that  notion  absurd.  Sir  William  Eamsay  has 
actually  succeeded  in  changing  one  element  into  an- 
other and  radium  and  helium  are  seen  changing  into 
each  other,  until  now  we  are  quite  ready  to  think  of 
transmutation  placidly.  The  Philosopher's  Stone 
used  to  seem  a  great  absurdity  until  our  recent  ex- 
perience with  radium,  which  is  to  some  extent  at 
least  the  philosopher's  stone,  since  it  brings  about 
the  change  of  certain  supposed  elements  into  others. 
A  distinguished  American  chemist  said  not  long  ago 
that  he  would  like  to  extract  all  the  silver  from  a 
large  body  of  lead  ore  in  which  it  occurs  so  com- 
monly, and  then  come  back  after  twenty  years  and 
look  for  further  traces  of  silver,  for  he  felt  sure  that 
they  would  be  found  and  that  lead  ore  is  probably 
always  producing  silver  in  small  quantities  and 
copper  ore  is  producing  gold. 

Most  people  will  be  inclined  to  ask  where  the  fruits 
of  this  undergraduate  teaching  of  science  are  to  be 
found.  They  are  inclined  to  presume  that  science 
was  a  closed  book  to  the  men  and  women  of  that  time. 
It  is  not  hard,  however,  to  point  the  effect  of  the 


418  OLD-TIME  MAKERS  OF  MEDICINE 

scientific  training  in  the  writings  of  the  times.  Dante 
is  a  typical  university  man  of  the  period.  He  was 
at  several  Italian  universities,  was  at  Paris  and  per- 
haps at  Oxford.  His  writings  are  full  of  science. 
Professor  Kuhns,  of  Wesleyan,  in  his  book  "  The 
Treatment  of  Nature  in  Dante,"  has  pointed  out 
how  much  Dante  knows  of  science  and  of  nature. 
Few  of  the  poets  not  only  of  his  own  but  of  any 
time  have  known  more.  There  are  only  one  or 
two  writers  of  poetry  in  our  time  who  go 
with  so  much  confidence  to  nature  and  the 
scientific  interpretation  of  her  for  figures  for  their 
poetry.  The  astronomy,  the  botany,  the  zoology 
of  Albertus  Magnus  and  Thomas  Aquinas,  Dante 
knew  very  well  and  used  confidently  for  fig- 
urative purposes.  Anyone  who  is  inclined  to  think 
nature  study  a  new  idea  in  the  world  forgets,  or 
has  never  known,  his  Dante.  The  birds  and  the  bees, 
the  flowers,  the  leaves,  the  varied  aspects  of  clouds 
and  sea,  the  phenomena  of  phosphorescence,  the 
intimate  habits  of  bird  and  beast  and  the  ways  of 
the  plants,  as  well  as  all  the  appearances  of  the 
heavens,  Dante  knew  very  well  and  in  a  detail  that 
is  quite  surprising  when  we  recall  how  little  nature 
study  is  supposed  to  have  attracted  the  men  of  his 
time.  Only  that  his  readers  appreciated  it  all,  Dante 
would  surely  not  have  used  his  scientific  erudition 
so  constantly. 

So  much  for  the  undergraduate  department  of  the 
universities  of  the  Middle  Ages,  and  the  view  is  abso- 
lutely fair,  for  these  were  the  men  to  whom  the 
students  flocked  by  thousands.  They  were  teaching 
science,  not  literature.  They  were  discussing  physics 
as  well  as  metaphysics,  psychology  in  its  phenomena 
as  well  as  philosophy,  observation  and  experiment 
as  well  as  logic,  the  ethical  sciences,  economics,  prac- 
tically all  the  scientific  ideas  that  were  needed  in 
their  generation — and  that  generation  saw  the  rise 


APPENDIX  419 

of  the  universities,  the  finishing  of  the  cathedrals, 
the  building  of  magnificent  town  halls  and  castles 
and  beautiful  municipal  buildings  of  many  kinds,  in- 
cluding hospitals,  the  development  of  the  Hansa 
League  in  commerce,  and  of  wonderful  manufac- 
turers of  all  the  textiles,  the  arts  and  crafts,  as 
well  as  the  most  beautiful  book-making  and  art  and 
literature.  We  could  be  quite  sure  that  the  men  who 
solved  all  the  other  problems  so  well  could  not  have 
been  absurd  only  in  their  treatment  of  science.  Any- 
one who  reads  their  books  will  be  quite  sure  of  that. 

While  most  people  might  be  ready,  then,  to  con- 
fess that  possibly  Huxley  was  not  mistaken  with 
regard  to  the  undergraduate  department  of  the  uni- 
versities, most  of  them  would  feel  sure  that  at  least 
the  graduate  departments  were  sadly  deficient  in 
accomplishment.  Once  more  this  is  entirely  an  as- 
sumption.   The  facts  are  all  against  any  such  idea. 

There  were  three  graduate  departments  in  most 
of  the  universities — theology,  law,  and  medicine. 
While  physical  scientists  are  usually  not  cognizant 
of  it  apparently,  theology  is  a  science,  a  department 
of  knowledge  developed  scientifically,  and  most  of 
these  medieval  universities  did  more  for  its  scien- 
tific development  than  the  schools  of  any  other 
period.  Quite  as  much  may  be  said  for  philosophy, 
for  there  are  many  who  hesitate  to  attribute  any 
scientific  quality  to  modern  developments  in  the  mat- 
ter. As  for  law,  this  is  the  great  period  of  the 
foundation  of  scientific  law  development;  the  Eng- 
lish common  law  was  formulated  by  Bracton,  the 
deep  foundations  of  basic  French  and  Spanish  law 
were  laid,  and  canon  law  acquired  a  definite  scientific 
character  which  it  was  always  to  retain.  All  this 
was  accomplished  almost  entirely  by  the  professors 
in  the  law  departments  of  the  universities. 

It  was  in  medicine,  however,  where  most  people 
would  be  quite  sure  without  any  more  ado  that  noth- 


420  OLD-TIME  MAKERS  OF  MEDICINE 

ing  worth  while  talking  about  was  being  done,  that 
the  great  triumphs  of  graduate  teaching  at  the  me- 
dieval universities  were  secured.  Here  more  than 
anywhere  else  is  there  room  for  supreme  surprise  at 
the  quite  unheard-of  anticipations  of  our  modern 
medicine  and,  stranger  still,  as  it  may  seem,  of  our 
modern  surgery. 

The  law  regulating  the  practice  of  medicine  in  the 
Two  Sicilies  about  the  middle  of  the  thirteenth  cen- 
tury shows  us  the  high  standard  of  medical  educa- 
tion. Students  were  required  to  have  three  years 
of  preliminary  study  at  the  university,  four  years 
in  the  medical  department,  and  then  practise  for  a 
year  with  a  physician  before  they  were  allowed  to 
practise  for  themselves.  If  they  wanted  to  practise 
surgery,  an  extra  year  in  the  study  of  anatomy  was 
required.  I  published  the  text  of  this  law,  which 
was  issued  by  the  Emperor  Frederick  II  about  1241, 
in  the  Journal  of  the  American  Medical  Association 
three  years  ago.  It  also  regulated  the  practice  of 
pharmacy.  Drugs  were  manufactured  under  the  in- 
spection of  the  government  and  there  was  a  heavy 
penalty  for  substitution,  or  for  the  sale  of  old  inert 
drugs,  or  improperly  prepared  pharmaceutical  ma- 
terials. If  the  government  inspector  violated  his 
obligations  as  to  the  oversight  of  drug  preparations 
the  penalty  was  death.  Nor  was  this  law  of  the  Em- 
peror Frederick  an  exception.  We  have  the  charters 
of  a  number  of  medical  schools  issued  by  the  Popes 
during  the  next  century,  all  of  which  require  seven 
years  or  more  of  university  study,  four  of  them  in 
the  medical  department,  before  the  doctor's  degree 
could  be  obtained.  When  new  medical  schools  were 
founded  they  had  to  have  professors  from  certain 
well-recognized  schools  on  their  staff  at  the  begin- 
ning in  order  to  assure  proper  standards  of  teaching, 
and  all  examinations  were  conducted  under  oath- 
bound  secrecy  and  with  the  heaviest  obligations  on 


APPENDIX  421 

professors  to  be  assured  of  the  knowledge  of  students 
before  allowing  them  to  pass. 

It  might  be  easy  to  think,  and  many  people  are 
prone  to  do  so,  that  in  spite  of  the  long  years  of 
study  required  there  was  really  very  little  to  study 
in  medicine  at  that  time.  Those  who  think  so  should 
read  Professor  Clifford  Allbutt's  address  on  the 
"  Historical  Eelations  of  Medicine  and  Surgery  " 
delivered  at  the  World's  Fair  at  St.  Louis  in  1904. 
He  has  dwelt  more  on  surgery  than  on  medicine,  but 
he  makes  it  very  clear  that  he  considers  that  the 
thinking  professors  of  medicine  of  the  later  Middle 
Ages  were  doing  quite  as  serious  work  in  their  way 
as  any  that  has  been  done  since.  They  were  care- 
fully studying  cases  and  writing  case  histories,  they 
were  teaching  at  the  bedside,  they  were  making  val- 
uable observations,  and  they  were  using  the  means 
at  their  command  to  the  best  advantage.  Of  course 
there  are  many  absurdities  in  their  therapeutics,  but 
then  we  must  not  forget  there  have  always  been 
many  absurdities  in  therapeutics  and  that  we  are  not 
free  from  them  in  our  day.  Professor  Richet,  at 
the  University  of  Paris,  said  not  long  ago:  "  The 
therapeutics  of  any  generation  is  quite  absurd  to  the 
second  succeeding  generation. ' '  "We  shall  not  blame 
the  medieval  generations  for  having  accepted  reme- 
dies that  afterwards  proved  inert,  for  every  genera- 
tion has  done  that,  even  our  own. 

Their  study  of  medicine  was  not  without  lasting 
accomplishment,  however.  They  laid  down  the  indi- 
cations and  the  dosage  for  opium.  They  used  iron 
with  success,  they  tried  out  many  of  the  bitter  tonics 
among  the  herbal  medicines,  and  they  used  laxatives 
and  purgatives  to  good  advantage.  Down  at  Mont- 
pellier,  Gilbert,  the  Englishman,  suggested  red  light 
for  smallpox  because  it  shortened  the  fever,  lessened 
the  lesions,  and  made  the  disfigurement  much  less. 
Finsen  was  given  the  Nobel  prize  partly  for  re-dis- 


422  OLD-TIME  MAKERS  OF  MEDICINE 

covery  of  this.  They  segregated  erysipelas  and  so 
prevented  its  spread.  They  recognized  the  con- 
tagiousness of  leprosy,  and  though  it  was  probably 
as  widespread  as  tuberculosis  is  at  the  present  time, 
they  succeeded  not  only  in  controlling  but  in  eventu- 
ally obliterating  it  throughout  Europe. 

It  was  in  surgery,  however,  that  the  greatest  tri- 
umphs of  teaching  of  the  medieval  universities  were 
secured.  Most  people  are  inclined  to  think  that 
surgery  developed  only  in  our  day.  The  great 
surgeons  of  the  thirteenth  and  fourteenth  centuries, 
however,  anticipated  most  of  our  teaching.  They 
investigated  the  causes  of  the  failure  of  healing  by 
first  intention,  recognized  the  danger  of  wounds  of 
the  neck,  differentiated  the  venereal  diseases,  de- 
scribed rabies,  and  knew  much  of  blood  poisoning, 
and  operated  very  skilfully.  We  have  their  text- 
books of  surgery  and  they  are  a  never-ending  source 
of  surprise.  They  operated  on  the  brain,  on  the 
thorax,  on  the  abdominal  cavity,  and  did  not  hesi- 
tate to  do  most  of  the  operations  that  modern  sur- 
geons do.  They  operated  for  hernia  by  the  radical 
cure,  though  Mondeville  suggested  that  more  people 
were  operated  on  for  hernia  for  the  benefit  of  the 
doctor's  pocket  than  for  the  benefit  of  the  patient. 
Guy  de  Chauliac  declared  that  in  wounds  of  the  in- 
testines patients  would  die  unless  the  intestinal 
lacerations  were  sewed  up,  and  he  described  the 
method  of  suture  and  invented  a  needle  holder.  We 
have  many  wonderful  instruments  from  these  early 
days  preserved  in  pictures  at  least,  that  show  us 
how  much  modern  advance  is  merely  re-invention. 

They  understood  the  principles  of  aseptic  surgery 
very  well.  They  declared  that  it  was  not  necessary 
"  that  pus  should  be  generated  in  wounds."  Pro- 
fessor Clifford  Allbutt  says : 

They  washed  the  wound  with  wine,  scrupulously  removing  every 
foreign  particle;  then  they  brought  the  edges  together,  not  allowing 


APPENDIX  423 

wine  or  anything  else  to  remain  within — dry  adhesive  surfaces  were 
their  desire.  Nature,  they  said,  produces  the  means  of  union  in  a 
viscous  exudation,  or  natural  balm,  as  it  was  afterwards  called  by 
Paracelsus,  Pare*,  and  Wurtz.  In  older  wounds  they  did  their  best 
to  obtain  union  by  cleansing,  desiccation,  and  refreshing  of  the 
edges.  Upon  the  outer  surface  they  laid  only  lint  steeped  in  wine. 
Powders  they  regarded  as  too  desiccating,  for  powder  shuts  in  decom- 
posing matters;  wine  after  washing,  purifying,  and  drying  the  raw 
surfaces  evaporates. 

Almost  needless  to  say  these  are  exactly  the  prin- 
ciples of  aseptic  surgery.  The  wine  was  the  best 
antiseptic  that  they  could  use  and  we  still  use  alcohol 
in  certain  cases.  It  would  seem  to  many  quite  im- 
possible that  such  operations  as  are  described  could 
have  been  done  without  anesthetics,  but  they  were 
not  done  without  anaesthetics.  There  were  two  or 
three  different  forms  of  anaesthesia  used  during  the 
thirteenth  and  fourteenth  centuries.  One  method 
employed  by  Ugo  da  Lucca  consisted  of  the  use  of 
an  inhalant.  We  do  not  know  what  the  material 
employed  was.  There  are  definite  records,  however, 
of  its  rather  frequent  employment. 

What  a  different  picture  of  science  at  the  medieval 
universities  all  this  makes  from  what  we  have  been 
accustomed  to  hear  and  read  with  regard  to  them.  It 
is  difficult  to  understand  where  the  old  false  impres- 
sions came  from*.  The  picture  of  university  work 
that  recent  historical  research  has  given  us  shows 
us  professors  and  students  busy  with  science  in  every 
department,  making  magnificent  advances,  many  of 
which  were  afterwards  forgotten,  or  at  least  allowed 
to  lapse  into  desuetude. 

The  positive  assertions  with  regard  to  old-time 
ignorance  were  all  made  in  the  course  of  religious 
controversy.  In  English-speaking  countries  partic- 
ularly it  became  a  definite  purpose  to  represent  the 
old  Church  as  very  much  opposed  to  education  of  all 
kinds  and  above  all  to  scientific  education.  There 
is  not  a  trace  of  that  to  be  found  anywhere,  but  there 
were  many  documents  that  were  appealed  to  to  con- 


424  OLD-TIME  MAKERS  OF  MEDICINE 

firm  the  protestant  view.  There  was  a  Papal  bull, 
for  instance,  said  to  forbid  dissection.  When  read 
it  proves  to  forbid  the  cutting  up  of  bodies  to  carry 
them  to  a  distance  for  burial,  an  abuse  wbich  caused 
the  spread  of  disease,  and  was  properly  prohibited. 
The  Church  prohibition  was  international  and  there- 
fore effective.  At  the  time  the  bull  was  issued  there 
were  twenty  medical  schools  doing  dissection  in 
Italy  and  they  continued  to  practise  it  quite  undis- 
turbed during  succeeding  centuries.  The  Papal  phy- 
sicians were  among  the  greatest  dissectors.  Dis- 
sections were  done  at  Eome  and  the  cardinals  at- 
tended them.  Bologna  at  the  height  of  its  fame  was 
in  the  Papal  States.  All  this  has  been  ignored  and 
the  supposed  bull  against  anatomy  emphasized  as 
representing  the  keynote  of  medical  and  surgical  his- 
tory. Then  there  was  a  Papal  decree  forbidding  the 
making  of  gold  and  silver.  This  was  said  to  forbid 
chemistry  or  alchemy  and  so  prevent  scientific  prog- 
ress. The  history  of  the  medical  schools  of  the  time 
shows  that  it  did  no  such  thing.  The  great  al- 
chemists of  the  time  doing  really  scientific  work  were 
all  clergymen,  many  of  them  very  prominent  ecclesi- 
astics. 

Just  in  the  same  way  there  were  said  to  be  decrees 
of  the  Church  councils  forbidding  the  practice  of 
surgery.  President  White  says  in  his  "  Warfare 
of  Science  with  Theology  in  Christendom, "  that, 
as  a  consequence  of  these,  surgery  was  in  dishonor 
until  the  Emperor  Wenceslaus,  at  the  beginning  of 
the  fifteenth  century,  ordered  that  it  should  be  re- 
stored to  estimation.  As  a  matter  of  fact,  during 
the  two  centuries  immediately  preceding  the  first 
years  of  the  fifteenth  century,  surgery  developed 
very  wonderfully,  and  we  have  probably  the  most 
successful  period  in  all  the  history  of  surgery  ex- 
cept possibly  our  own.  The  decrees  forbade  monks 
to  practise  surgery  because  it  led  to  certain  abuses. 


APPENDIX  425 

Those  who  found  these  decrees  and  wanted  to  be- 
lieve that  they  prevented  all  surgical  development 
simply  quoted  them  and  assumed  there  was  no 
surgery.  The  history  of  surgery  at  this  time  is 
one  of  the  most  wonderful  chapters  in  human 
progress. 

The  more  we  know  of  the  Middle  Ages  the  more 
do  we  realize  how  much  they  accomplished  in  every 
department  of  intellectual  effort.  Their  develop- 
ment of  the  arts  and  crafts  has  never  been  equalled 
in  the  modern  time.  They  made  very  great  litera- 
ture, marvellous  architecture,  sculpture  that  rivals 
the  Greeks',  painting  that  is  still  the  model  for  our 
artists,  surpassing  illuminations;  everything  that 
they  touched  became  so  beautiful  as  to  be  a  model 
for  all  the  after  time.  They  accomplished  as  much 
in  education  as  they  did  in  all  the  other  arts,  their 
universities  had  more  students  than  any  that  have 
existed  down  to  our  own  time,  and  they  were  en- 
thusiastic students  and  their  professors  were  ardent 
teachers,  writers,  observers,  investigators.  While 
we  have  been  accustomed  to  think  of  them  as  neglect- 
ing science,  their  minds  were  occupied  entirely  with 
science.  They  succeeded  in  anticipating  much  more 
of  our  modern  thought,  and  even  scientific  progress, 
than  we  have  had  any  idea  until  comparatively  re- 
cent years.  The  work  of  the  later  Middle  Ages  in 
mathematics  is  particularly  strong,  and  was  the 
incentive  for  many  succeeding  generations.  Eoger 
Bacon  insisted  that,  without  mathematics,  there 
was  no  possibility  of  real  advance  in  physical  sci- 
ence. They  had  the  right  ideas  in  every  way. 
While  they  were  occupied  more  with  the  philo- 
sophical and  ethical  sciences  than  we  are,  these  were 
never  pursued  to  the  neglect  of  the  physical  sciences 
in  the  strictest  sense  of  that  term. 

Is  it  not  time  that  we  should  drop  the  foolish  no- 
tions that  are  very  commonly  held  because  we  know 


426  OLD-TIME  MAKERS  OF  MEDICINE 

nothing  about  the  Middle  Ages — and,  therefore,  the 
more  easily  assume  great  knowledge — and  get  back 
to  appreciate  the  really  marvellous  details  of  educa- 
tional and  scientific  development  which  are  so  inter- 
esting and  of  so  much  significance  at  this  time? 


APPENDIX  III 
MEDIEVAL  POPULARIZATION  OF  SCIENCE 

The  idea  of  collecting  general  information  from 
many  sources,  of  bringing  it  together  into  an  easily 
available  form,  so  as  to  save  others  labor,  of  writing 
it  out  in  compendious  fashion,  so  that  it  could  readily 
pass  from  hand  to  hand,  is  likely  to  be  considered 
typically  modern.  As  a  matter  of  fact,  the  Middle 
Ages  furnish  us  with  many  examples  of  the  pop- 
ularization of  science,  of  the  writing  of  compendia 
of  various  kinds,  of  the  gathering  of  information  to 
save  others  the  trouble,  and,  above  all,  of  the  making 
of  what,  in  the  modern  time,  we  would  call  encyclo- 
pedias. Handbooks  of  various  kinds  were  issued, 
manuals  for  students  and  specialists,  and  many  men 
of  broad  scholarship  in  their  time  devoted  them- 
selves to  the  task  of  making  the  acquisition  of  knowl- 
edge easy  for  others.  This  was  true  not  only  for 
history  and  philosophy  and  literature,  but  also  for 
science.  It  is  not  hard  to  find  in  each  century  of 
the  Middle  Ages  some  distinguished  writer  who  de- 
voted himself  to  this  purpose,  and  for  the  sake  of 
the  light  that  it  throws  on  these  scholars,  and  the 
desire  for  information  that  must  have  existed  very 
commonly  since  they  were  tempted  to  do  the  work, 
it  seems  worth  while  to  mention  here  their  names, 
and  those  of  the  books  they  wrote,  with  something 
of  their  significance,  though  the  space  will  not  per- 
mit us  to  give  here  much  more  than  a  brief  catalogue 
raisonne  of  such  works. 

Very  probably  the  first  who  should  be  mentioned 
in  the  list  is  Boethius,  who  flourished  in  the  early 

427 


428  OLD-TIME  MAKERS  OF  MEDICINE 

part  of  the  sixth  century.  He  owed  much  of  his  edu- 
cation to  his  adoptive  father,  afterwards  his  father- 
in-law,  Symmachus,  who,  with  Festus,  represented 
scholarship  at  the  court  of  the  Gothic  King,  Theo- 
doric  of  Verona.  These  three — Festus,  Symmachus, 
and  Boethius — brought  such  a  reputation  for  knowl- 
edge to  the  court  that  they  are  responsible  for  many 
of  the  wonderful  legends  of  Dietrich  of  Bern,  as 
Theodoric  came  to  be  called  in  the  poems  of  the 
medieval  German  poets.  The  three  distinguished 
and  devoted  scholars  did  much  to  save  Greek  culture 
at  a  time  when  its  extinction  was  threatened,  and 
Boethius  particularly  left  a  series  of  writings  that 
are  truly  encyclopedic  in  character.  There  are  five 
books  on  music,  two  on  arithmetic,  one  on  geometry, 
translations  of  Aristotle's  treatises  on  logic,  with 
commentaries;  of  Porphyry's  "  Isagoge,"  with  com- 
mentaries, and  a  commentary  on  Cicero's  "  Topica." 
Besides,  he  wrote  several  treatises  in  logic  and 
rhetoric  himself,  one  on  the  use  of  the  syllogism,  and 
one  on  topics,  and  in  addition  a  series  of  theological 
works.  His  great  "  Consolations  of  Philosophy  " 
was  probably  the  most  read  book  in  the  early  Middle 
Ages.  It  was  translated  into  Anglo-Saxon  by 
King  Alfred,  into  old  German  by  Notker  Teuto- 
nicus,  the  German  monk  of  St.  Gall,  and  its  influence 
may  be  traced  in  Beowulf,  in  Chaucer,  in  High  Ger- 
man poetry,  in  Anglo-Norman  and  Provengal  pop- 
ular poetry,  and  also  in  early  Italian  verse.  Above 
all,  the  "  Divine  Comedy  "  has  many  references  to 
it,  while  the  "  Convito  "  would  seem  to  show  that 
it  was  probably  the  book  that  most  influenced  Dante. 
Though  it  is  impossible  to  confirm  by  documentary 
evidence  the  generally  accepted  idea  that  Boethius 
died  a  martyr  for  Christianity,  the  tradition  can  be 
traced  so  far  back,  and  it  has  been  so  generally  ac- 
cepted that  this  seems  surely  to  have  been  the  case. 
The  fact  is  interesting,  as  showing  the  attitude  of 


APPENDIX  429 

scholars  towards  the  Church  and  of  the  Church 
towards  scholarship  thus  early. 

The  next  great  name  in  the  tradition  should  prob- 
ably be  that  of  Cassiodorus,  the  Roman  writer  and 
statesman,  prime  minister  of  Theodoric,  who,  after 
a  busy  political  life,  retired  to  his  estate  at  Viva- 
rium, and,  in  imitation  of  St.  Benedict,  who  had  re- 
cently established  a  monastery  at  Monte  Cassino, 
founded  a  monastery  there.  He  is  said  to  have  lived 
to  the  age  of  ninety-three.  His  retirement  favored 
this  long  life,  for,  after  the  death  of  Theodoric, 
troublous  times  came,  and  civil  war,  and  only  his 
monastic  privileges  saved  him  from  the  storm  and 
stress  of  the  times.  He  had  been  interested  in  lit- 
erature and  the  collection  of  information  of  many 
kinds  before  his  retirement,  and  it  is  not  unlikely 
that  his  recognition  of  the  fact  that  the  monastic 
life  offered  opportunities  for  the  pursuit  of  this,  un- 
der favorable  circumstances,  led  him  to  take  it  up. 

While  still  a  statesman  he  wrote  a  series  of  works 
relating  to  history  and  politics  and  public  affairs 
generally.  These  consisted  mainly  of  chronicles 
and  panegyrics,  and  twelve  books  of  miscellanies 
called  VariaB.  After  his  retirement  to  the  mon- 
astery, a  period  of  ardent  devotion  to  writing  be- 
gins, and  a  great  number  of  books  were  issued.  He 
evidently  gathered  round  him  a  number  of  men 
whom  he  inspired  with  his  spirit,  or,  perhaps, 
selected,  because  he  found  that,  while  they  had  a 
taste  for  a  quiet,  peaceful  spiritual  life,  they  were 
also  devoted  to  the  accumulation  and  diffusion  of 
knowledge.  A  series  of  commentaries  on  portions 
of  the  Scriptures  was  written,  the  Jewish  antiquities 
of  Josephus  translated,  and  the  ecclesiastical  his- 
tories of  Theodoric,  Sozomen,  and  Socrates  made 
available  in  Latin.  Cassiodorus  himself  is  said  to 
have  made  a  compendium  of  these,  called  the  ' i  His- 
toria  Tripartita,"  which  was  much  used  as  a  manual 


430  OLD-TIME  MAKERS  OF  MEDICINE 

of  history  during  succeeding  centuries.  Then  there 
were  treatises  on  grammar,  on  orthography,  and  a 
series  of  works  on  mathematics.  In  all  of  his  writ- 
ings Cassiodorus  shows  a  special  fondness  for  the 
symbolism  of  numbers. 

There  is  a  well-grounded  tradition  that  he  in- 
sisted on  the  study  of  the  Greek  classics  of  medical 
literature,  especially  Hippocrates  and  Galen,  and 
awakened  the  interest  of  the  monks  in  the  necessity 
for  making  copies  of  these  fathers  of  medicine.  The 
tradition  that  he  established  at  Vivarium  is  also 
found  to  have  existed  at  Monte  Cassino  among  the 
Benedictines,  and,  doubtless,  to  this  is  to  be  at- 
tributed the  foundation  of  the  medical  school  of 
Salerno,  where  Benedictine  influence  was  so  strong. 
It  is  probable,  therefore,  that  to  Cassiodorus  must 
be  attributed  the  preservation  in  as  perfect  a  state 
as  we  have  them  of  the  old  Greek  medical  writers. 

His  main  idea  was,  of  course,  the  study  of  Scrip- 
tures, but  with  just  as  many  helps  as  possible.  He 
thought  that  commentators,  and  historians,  not  alone 
Christian,  but  also  Hebrew  and  Pagan,  should  be 
studied  to  illustrate  it,  and  then  the  commentaries  of 
the  Latin  fathers,  so  that  a  thoroughly  rounded 
knowledge  of  it  should  be  obtained.  He  thus  began 
an  "  Encyclopedia  Biblica,"  and  set  a  host  of  work- 
ers at  its  accomplishment. 

Every  country  in  Europe  shared  this  movement 
for  the  diffusion  of  information  during  the  early 
Middle  Ages,  and  the  works  of  men  from  each  of 
these  countries  in  succeeding  centuries  has  come 
down  to  us,  preserved  in  spite  of  all  the  vicissitudes 
to  which  they  were  so  liable  during  the  centuries 
before  the  invention  of  printing  and  the  easy  multi- 
plication of  books.  To  many  people  it  will  seem 
surprising  to  learn  that  the  next  evidence  of  deep 
broad  interest  in  knowledge  is  to  be  found  in  the 
next  century  in  the  distant  west  of  Europe,  in  the 


APPENDIX  431 

Spanish  Peninsula.  It  is  a  long  step  from  the  semi- 
barbaric  splendor  of  the  Gothic  court  at  Verona,  to 
the  bishop's  palace  in  Seville  in  Andalusia.  The 
two  cities  are  separated  by  what  is  no  inconsider- 
able distance  in  our  day.  In  the  seventh  century 
they  must  have  seemed  almost  at  the  other  end  of 
the  world  from  each  other.  Those  who  recall  what 
we  have  insisted  on  in  several  portions  of  the  body 
of  this  work  with  regard  to  the  high  place  Spanish 
genius  won  for  itself  in  the  Roman  Empire,  and  how 
much  of  culture  among  the  Spaniards  of  that  time 
the  occurrence  of  so  many  important  writers  of 
that  nationality  must  imply,  will  not  be  surprised  at 
the  distinguished  work  of  a  great  Christian  Spanish 
writer  of  the  seventh  century. 

Indeed,  it  would  be  only  what  might  be  expected 
for  evidences  of  early  awakening  of  the  broadest  cul- 
ture to  be  found  in  Spain.  The  important  name  in 
the  popularization  of  science  in  the  seventh  cen- 
tury is  St,  Isidore  of  Seville.  He  made  a  compen- 
dium of  all  the  scattered  scientific  traditions  and 
information  of  his  time  with  regard  to  natural 
phenomena  in  a  sort  of  encyclopedia  of  science. 
This  consisted  of  twenty  books — chapters  we  would 
call  them  now — treating  almost  de  omni  re  scibili  et 
quibusdam  aliis  (everything  knowable  and  a  few 
other  things  besides).  It  is  possible  that  the  work 
may  have  been  written  by  a  number  of  collaborators 
under  the  patronage  of  the  bishop,  though  there  is 
no  sure  indication  of  this  to  be  found  either  in  the 
volume  itself  or  even  contemporary  history.  All 
the  ordinary  scientific  subjects  are  treated.  Astron- 
omy, geography,  mineralogy,  botany,  and  even  man 
and  the  animals  have  each  a  special  chapter. 
Pouchet,  in  his  "  History  of  the  Natural  Sciences 
During  the  Middle  Ages,"  calls  attention  to  the  fact 
that,  in  grouping  the  animals  for  collective  treat- 
ment in  the  different  chapters,  sometimes  the  most 


432  OLD-TIME  MAKERS  OF  MEDICINE 

heterogeneous  creatures  are  brought  under  a  com- 
mon heading.  Among  the  fishes,  for  instance,  are 
classed  all  living  things  that  are  found  in  water. 
The  whale  and  the  dolphin,  as  well  as  sponges,  and 
oysters,  and  crocodiles,  and  sea  serpents,  and  lob- 
sters, and  hippopotamuses,  all  find  a  place  together, 
because  of  the  common  watery  habitation.  The 
early  Spanish  Churchman  would  seem  to  have  had 
an  enthusiastic  zeal  for  complete  classification  that 
would  surely  have  made  him  a  strenuous  modern 
zoologist. 

The  next  link  in  the  tradition  of  encyclopedic  work 
is  the  Venerable  Bede,  whose  character  was  more 
fully  honored  by  the  decree  on  November  13,  1899, 
by  Pope  Leo  XIII  declaring  him  a  Doctor  of  the 
Church.  Bede  was  the  fruit  of  that  ardent  scholar- 
ship which  had  risen  in  England  as  a  consequence 
of  the  introduction  of  Christianity.  It  had  been 
fostered  by  the  coming  of  scholar  saints  from  Ire- 
land, but  was,  unfortunately,  disturbed  by  the  in- 
cursions of  the  Danes.  While  Bede  is  known  for 
his  greatest  work,  the  "  Ecclesiastical  History  of 
the  English  People,"  which  gives  an  account  of 
Christianity  in  England  from  its  beginning  until  his 
own  day,  he  wrote  many  other  works.  His  history 
is  the  foundation  of  all  our  knowledge  of  early 
British  history,  secular  as  well  as  religious,  and  has 
been  praised  by  historical  writers  of  all  ages,  who 
turned  to  it  for  help  with  confidence.  He  wrote  a 
number  of  other  historical  works.  Besides,  he 
wrote  books  on  grammar,  orthography,  the  metrical 
art,  on  rhetoric,  on  the  nature  of  things,  the  sea- 
sons, and  on  the  calculation  of  the  seasons.  These 
latter  books  are  distinctly  scientific.  His  contribu- 
tions to  Gregorian  Music  are  now  of  great  value. 

After  this,  Alcuin  and  the  monks,  summoned  by 
Charlemagne,  take  up  the  tradition  of  gathering  and 
diffusing  information,  and  the  great  monasteries  of 


APPENDIX  433 

Tours,  Fulda,  and  St.  Grail  carry  it  on.  Besides 
these,  in  the  ninth  century  Monte  Cassino  comes 
into  prominence  as  an  institution  where  much  was 
done  of  what  we  would  now  call  encyclopedic  work. 
After  his  retirement  from  Salerno  Constantine 
Africanus  made  his  translations  and  commentaries 
on  Arabian  medicine,  constituting  what  was  really 
a  medical  encyclopedia  of  information  not  readily 
available  at  that  time. 

After  this,  of  course,  the  tradition  is  taken  up 
by  the  universities,  and  it  is  only  when,  with  the 
thirteenth  century,  there  came  the  complete  develop- 
ment of  the  university  spirit,  that  encyclopedias 
reached  their  modern  expression.  Three  great  en- 
cylopedists,  Vincent  of  Beauvais,  Thomas  of  Can- 
timprato,  and  Bartholomseus  Anglicus,  are  the  most 
famous.  Vincent  consulted  all  the  authors  sacred 
and  profane  that  he  could  lay  hold  on,  and  the  num- 
ber was,  indeed,  prodigious.  I  have  given  some  ac- 
count of  him  in  "  The  Thirteenth  Greatest  of  Cen- 
turies "  (Catholic  Summer  School  Press,  New  York, 
third  edition,  1910). 

It  would  be  very  easy  to  conclude  that  these  en- 
cyclopedias, written  by  clergymen  for  the  general 
information  of  the  educated  people  of  the  times,  con- 
tain very  little  that  is  scientifically  valuable,  and 
probably  nothing  of  serious  medical  significance. 
Any  such  thought  is,  however,  due  entirely  to  un- 
familiarity  with  the  contents  of  these  works.  They 
undoubtedly  contain  absurdities,  they  are  often  full 
of  misinformation,  they  repeat  stories  on  dubious 
authority,  and  sometimes  on  hearsay,  but  usually 
the  source  of  their  information  is  stated,  and  espe- 
cially where  it  is  dubious,  as  if  they  did  not  care  to 
state  marvels  without  due  support.  Books  of  pop- 
ular information,  however,  have  always  had  many 
queer  things, — queer,  that  is,  to  subsequent  genera- 
tions,— and  it  is  rather  amusing  to  pick  up  an  en- 


434  OLD-TIME  MAKERS  OF  MEDICINE 

cyclopedia  of  a  century  ago,  much  less  a  millen- 
nium ago,  and  see  how  many  absurd  things  were  ac- 
cepted as  true.  The  first  edition  of  the  "  Encyclo- 
pedia Britannica, ' '  issned  one  hundred  and  fifty 
years  ago,  furnishes  an  easily  available  source  of 
the  absurdities  our  more  recent  forefathers  accepted. 
The  men  of  the  Middle  Ages,  however,  were  much 
better  observers  as  a  rnle,  and  nsed  much  more  crit- 
ical judgment,  according  to  their  lights,  than  we 
have  given  them  credit  for.  Often  the  information 
that  they  have  to  convey  is  not  only  valuable,  but 
well  digested,  thoroughly  practical,  and  sometimes  a 
marvellous  anticipation  of  some  of  our  most  modern 
thoughts.  There  is  one  of  these  encyclopedias  which, 
because  it  was  written  in  my  favorite  thirteenth 
century,  I  have  read  with  some  care.  It  is  simply 
a  development  of  the  work  of  preceding  clerical  en- 
cyclopedists, and  often  refers  to  them.  Because  it 
contains  some  typical  examples  of  the  better  sorts 
of  information  in  these  works,  I  have  thought  it 
worth  while  to  quote  two  passages  from  it.  The 
author  is  Bartholomseus  Anglicus,  and  the  quaint 
English  in  which  it  is  couched  is  quoted  from  ' '  Med- 
ical Lore  "  (London,  1893).  The  book  is  all  the 
more  interesting  because  in  a  dear  old  English  ver- 
sion, issued  about  1540,  the  spellings  of  which  are 
among  the  great  curiosities  of  English  orthography, 
it  was  often  read  and  consulted  by  Shakespeare,  who 
evidently  quotes  from  it  frequently,  for  not  a  little 
of  the  quaint  scientific  lore  that  he  uses  for  his 
figures  can  be  traced  to  expressions  used  in  this 
book. 

The  first  of  the  paragraphs  that  deserves  to  be 
quoted,  discusses  madness,  or,  as  we  would  call  it, 
lunacy,  and  sums  up  the  causes,  the  symptoms,  and 
the  treatment  quite  as  well  as  that  has  ever  been 
done  in  the  same  amount  of  space : 

Madness    cometh    sometime  of  passions  of  the  soul,  as  of  business 
and  of  great  thoughts,  of  sorrow  and  of  too  great  study,  and  of  dread: 


APPENDIX  435 

sometime  of  the  biting  of  a  wood  hound,  or  some  other  venomous 
beast;  sometime  of  melancholy  meats,  and  sometime  of  drink  of  strong 
wine.  And  as  the  causes  be  diverse,  the  tokens  and  signs  be  diverse. 
For  some  cry  and  leap  and  hurt  and  wound  themselves  and  other  men, 
and  darken  and  hide  themselves  in  privy  and  secret  places.  The  medi- 
cine of  them  is,  that  they  be  bound,  that  they  hurt  not  themselves  and 
other  men.  And  namely,  such  shall  be  refreshed,  and  comforted,  and 
withdrawn  from  cause  and  matter  of  dread  and  busy  thoughts.  And 
they  must  be  gladded  with  instruments  of  music,  and  some  deal  be  oc- 
cupied. ' 

The  second  discusses  in  almost  as  thorough  a  way 
the  result  of  the  bite  of  a  mad  dog.  The  old  Eng- 
lish word  for  mad,  wood,  is  constantly  used.  The 
causes,  the  symptoms,  and  course  of  the  disease,  and 
its  possible  prevention  by  early  treatment,  are  all 
discussed.  The  old  tradition  was  already  in  ex- 
istence that  sufferers  from  rabies  or  hydrophobia, 
as  it  is  called,  dreaded  water,  when  it  is  really  only 
because  the  spasm  consequent  upon  the  thought 
even  of  swallowing  is  painful  that  they  turn  from  it. 
That  tradition  has  continued  to  be  very  commonly 
accepted  even  by  physicians  down  to  our  own  day, 
so  that  Bartholomew,  the  Englishman,  in  the  thir- 
teenth century,  will  not  be  blamed  much  for  setting 
it  forth  for  popular  information  in  his  time  some 
seven  centuries  ago.  The  idea  that  free  bleeding 
would  bring  about  the  removal  of  the  virus  is  inter- 
esting, because  we  have  in  recent  years  insisted  in 
the  case  of  the  very  similar  disease,  tetanus,  on  al- 
lowing or  deliberately  causing  wounds  in  which  the 
tetanus  microbe  may  have  gained  an  entrance,  to 
bleed  freely. 

The  biting  of  a  wood  hound  is  deadly  and  venomous.  And  such 
venom  is  perilous.  For  it  is  long  hidden  and  unknown,  and  in- 
creaseth  and  multiplieth  itself,  and  is  sometimes  unknown  to  the 
year's  end,  and  then  the  same  day  and  hour  of  the  biting,  it  cometh 
to  the  head,  and  breedeth  frenzy.  They  that  are  bitten  of  a  wood 
hound  have  in  their  sleep  dreadful  sights,  and  are  fearful,  astonied, 
and  wroth  without  cause.  And  they  dread  to  be  seen  of  other  men, 
and  bark  as  hounds,  and  they  dread  water  most  of  all  things,  and 
are  afeared  thereof  full  sore  and  squeamous  also.  Against  the  biting 
of  a  wood  hound  wise  men  and  ready  use  to  make  the  wounds  bleed 
with  fire  or  with  iron,  that  the  venom  may  come  out  with  tho 
blood,  that  cometh  out  of  the  wound, 


INDEX 


'A 


Abbassides,  73 

Abba  Oumna,  70 

Abbas,   324 

Ab6lard,    189 

Abraham,   97,   98 

Abu   Dscbafer,    173 

Abulcasis,    123,    170,    226,    317, 

318,  323 
Abul  Farag,  51 
Abulkasim,   124 
Academy  of  Bagdad,  135 
Acid,  hydrochloric,  369 
Ackermann,  302 
Adalberon,   145 
Adelard  of  Bath,   134 
Adhesions,    128 
^Egidius,    150 
Aetius,   10,   117,   180,  317 
Aetius,   Amidenus,   28 
Afflacius,    151,    171 
Affinity,    372 
Agenius,  Otto,  227 
Agricola,   345 

A  Kempis,  Thomas,  345,  361 
Alanfrancus,  260 
Albertus  Magnus,  267,  306,  356, 

403 
Alchemist,    354 
Alcuin,   432 
Alderotti,    213 
Alexander  II,  Pope,  83 
Alexander   of   Hales,    108 
Alexander  of  Tralles,  10,  28,  39 
Alexandria,    135,    385 
Allbutt,    Sir   Clifford,    247,   254, 

257,   304,   355,   421 
Ali  Abbas,   121,  173,  266,  323 
Ali  Ben  el   Abbas,    170 
Almansor,  132 
Alphanus,  143,   145 
Amandaville,   264 
Anaesthesia,    17;    inhalation    of, 

295,  296 


Anaesthetics,  246 

Anathomia,   203 

Anatomy,  ignorance  of,  289;   of 

the  teeth,   326 
Anatomical  material,  224 
Anatomical  injection,  227 
Anatomical    preparations,    277 
Andrew  of  Piacenza,  248 
Animals,  motion  of,  414 
Anthemios,  40 
Angelico,    Fra,    360 
Angina,  32,  44,  332 
Anthon,  407 
Antimony,  362 
Antiseptic,   253 
Antisepsis,    17,   246 
Apocalypse,  the  chemical,  376 
Aquinas,  306,  403 
Arabian  lack  of  originality,  140 
Arabian  words  in  anatomy,   138 
Arabs,  7 
Arabisms,  237 
Archimattheas,    160 
Arcoli,  John  of,  208 
Arculanus,   323 
Arezzo,    248 

Arithmetical  complements,  340 
Armandaville,  264 
Arnold  of  Villanova,  290,  358 
Arrows,  extraction  of,  270 
Arpinum,   4 
Arsenic,  335 
Artemisia  maritima,  50 
Arterial  hemorrhage,   126 
Arthur  Legends,  218,  375,  392 
Arts,      7;      liberal,      149;      and 

crafts,    425 
Asepsis,   17,   244,   246,   387 
Aspasia,    180 
Astrology,   105;   and  astronomy, 

106,  418 
Asylums,    8 
Auenbrugger,   91,    166 
Authority,   269,  292,   404 
Authorship,  dual,  391 


437 


438 


OLD-TIME  MAKERS  OF  MEDICINE 


Automobile,  415 

Avenzoar,    80,    123,    130,    132 

Aver  roes     ( Averrhoes ) ,    80,    123, 

132,  230,  267 
Avicenna,     80,     128,     170,     266, 

268,    331 
Avignon,    16,   233 


B 


Baas,  61,  63 

Bachtischua,  56 

Bacon,  Roger,  107,  306,  356,  361, 

403 
Bagdad,   110,  111,  115,  134,  135 
Barbarians,  5 

Bartholomseus  Anglicus,  433 
Bartholomew,   172 
Basilios,    26 
Basil,  St.,  24 
Basila,    180 

Basil  Valentine,   20,    180,   349 
Basra,  111 
Bath,  103 
Bath,  milk,   131;  in  fever,   172; 

of  the  soul,  25 
Baverius,   209 

Baynes,  Henry  Samuel,  390 
Bede,  432 
Benedict,  St.,  178 
Benedictines,    12,    164 
Benedictine   Nuns,    191 
Beowulf,   428 
Berengarius,  209 
Bernard  of  Clairvaux,  192 
Bernard,  St.,  85 
Bertruccio,  209,  287 
Bertruccius,   229 
Binz,  Prof.  Carl,  336 
Birthplace,    Latin   writers,   4 
Black   Death,    304 
Boccaccio,   183,  306 
Body-snatching,  224 
Boerhaave,  38 
Boethius,    427 
Bokhara,   111 

Bologna,   16,   142,   202,   206,  248 
Book-learning,  371 
Botany,     413;     medieval,     414, 

418 
Botticelli,    360 
Bracton,   419 
Brain   substance,  loss  of,  294 


Brant,    361 

Brethren    of    the    Common   Life 
344 

Bridge  work,  dental,  315 

Broeck,  277 

Bronchoceles,    34 

Bruno  da  Longoburgo,   245,   248 

Bubonocele,    53 

Buffon,   406 

Bull,    supposed    against    dissec- 
tion, 424 

Busche,    344 

Bzowski,  S.  J.,  181 


C 


Csesalpinus,   2,    209 

Caius,   360 

Calenda,  Constance,  187 

Calendar,    correction    of,    340 

Calvo,   302 

Cancer,  255 

Cantor,    346 

Carmoly,  61 

Carthage,  165 

Cases,   desperate,  262 

Cassiodorus,    12,   429 

Cataract,  300 

Cato,  267 

Chanina    Ben    Chania,    66,    69 

Charlatans,    numbers    of,    274 

Charters,  medical  school,  420 

Charts,    19 

Chasdai    Ben   Schaprut,    79 

Chaucer,   306,  428 

Chauliac,    18,    285,    301,    319 

Chauliac,  bibliography,  308;  edi- 
tio  princeps,  312 

Chemical  compounds,  artificial, 
376 

Chirurgia  Magna,  261,  284 

Chirurgy,   19 

Chosroes  I,   109 

Church  and  Jews,  80;  and  anat- 
omy,   234;    and    surgery,    234 

Cicatrices,   beautiful,   255 

Cicero,  4,  427 

Cid,   The,   218,   375,   392 

Cimabue,   211 

Circulation  of   the  blood,   147 

Cities,   large,  5 

City  hospitals,  8;  for  the  sick, 
24,   296 


INDEX 


439 


City  physician,  251 
Clavius,  S.   J.,   Father,   340 
Classics  of  Medicine,   165 
Clement  of  Alexandria,   83;   VI, 

Pope,  83 
Cleopatra,    179 
Clepsydra,  341 
Clinical  experience,  378 
Clitoris  hypertrophy,  37 
Clysters,  279 
Cnidos,    135 
Colic,  279 

Collectio    Salernitana,    143,    238 
College  of  St.  Come,  26 
Colpeurynter,   128 
Columbus,  2,  209,  327,  329,  359 
Conception,  35 
Constantine     Africanus,     5,     24, 

123,    134,    145,    151,    163,   236, 

266,  433 
Constitution  of  the  sun,  339 
Consolations,   428 
Consumption,   44 
Conrad,   192 
Conrad   Mutianus,    344 
Contrecoup,   240 
Convito,  428 
Copernicus,  346 
Copho,  154,  205 
Cordova,  75,  92,  134,  135 
Cornelius,  38 
Corrosive   sublimate,   335 
Cos,   135 

Cosmas  and  Damien,  26 
Criticism,  higher,  7 
Crown,   dental,   316;   cap,   316 
Cusanus,  336 
Cures  of  Afflacius,  171 
Cuvier,   406 
Cycloid  curve,  346 


Dental  appliances,  316;  decay, 
318;  hygiene,  325;  surgery, 
327;    instruments,  320 

Dentatores,  320 

Dentrifices,  316 

Descartes,    133 

Desiderius,  145,  164,  168 

Deventer,  344 

Dezimeres,    302 

Diaphoresis,  47 

Diarbekir,  28 

Didacus  Lopez,   130 

Diet,  46,  116 

Dietetics,    99,    157 

Di  Liucci,  205 

Dinus  de  Garbo,  130 

Diogenes,   267 

Dioscorides,  79,  266,  385 

Diphtheria,  32 

Diseases  made  incurable,  274; 
eye,  300 

D'Israeli,   76 

Dissecting  material,  134 ; 
wounds,  227 

Dissection,  224;  supposed  pro- 
hibition of,  424 

Divine   Comedy,  428 

Divorce,  5 

Djondisabour,    71,    109 

Dock    (Miss),    401 

Dog,  rabid,  31 

Donolo,   78 

Drainage,  241,  249 

Dreams,    68 

Driesch,   399 

Dsehibril,   57 

Dschordschis,    56 

Du   Bouley,    199 

Duke,  Robert,    167 

Duns   Scotus,   108 


D 


Da  Lucca,  246 

Damascus,  111 

Daniel  Morley,  134 

Dante,    183,   211,    306,   407,   417 

Daremberg,  180,  303 

Darwin,   355,   399 

David,  97 

Decadence,    6 

Pe  Renzi,  143,  162,  182,  238,  239 


E 


Eclecticism,  248 

Eclipse,  22 

Ecstasis,   386 

Eddyites,   385 

Edessa,  9 

Egidius,  134 

Elixir  of  immortal  life,  25 

Embryology,  28 

Encyclopedia  biblica,  430 


440 


OLD-TIME  MAKERS  OF  MEDICINE 


Energy,  Conservation  of,  417 
Epilepsy,   43 
Epiplocele,   53 
Epiplo-enteroeele,  53 
Epithelioma,  37 
Epulis,  32 

Erasistratus,    221,    385 
Erasmus,  344,   361 
Esophagus,   33 
Ethics,  medical,  77 
Ethnography,    414 
Etruscans,  315 
Eusebius,    26 
Eustachius,   2,  209 
Eustachian    canal,    327,    329 
Examinations,  136 
Experience,  403 
Experiment,  master  of,  404 


F 


Fabiola,   11 

Fabricius      de      Acquapendente, 

125 
Fallopius,  302,  327 
Farad j   Ben  Salim,   79,   170 
Faragut,   79 

Father  of  Modern  Surgery,  283 
Faucon,   312 
Feminine    education,    178,    188; 

cycles   of,   200 
Ferrara,   248,    328 
Festus,   428 

Filling  of  the  teeth,  335 
Finsen,  421 
First  intention,   18 
Fish   bones,   51 
Florence,  206,   248 
Floyer,  336 

Forefathers    in    medicine,    380 
Foreign  body,   33 
Foreign  bodies,  48 
Forli,    206 

Foster,  Sir  Michael,  354 
Foundlings,  8 
Foundling  asylums,  25 
Founder       of       Pharmaceutical 

Chemistry,  353 
Four  Masters,  154,  238,  242,  243, 

273 
Fractures,    240;    of    pubic    arch, 

128;    of    base,    242;    of    skull, 

244;  split  or  crack,  243 


Francis,  Dr.   Samuel,  223 
Frederick  I,  192;   II,  147 
Freind,  112,  302 
Friedenwald,  64 
Friuli,  206 

G 

Gaddesden,  287 

Galeatus      de      Sancta      Sophia, 

130 
Galileo,   355 
Galen,    3,    13,    35,    43,    73,    91, 

115,    117,   129,   179,   266,   230, 

204,  430,  385 
Galenists,   120 
Galvani,    166,   209 
Gario  Pontus,  43 
Gentilis   de   Fulgineis,   130 
Geography,  physical,  413 
Geometric  transmutation,  340 
Gerard  of  Cremona,  134,  170 
Ghetto,  62 
Giffert,  Prof.,  396 
Gilbert,  421 

Giliani,  Alessandra,    188 
Gilles  de  Corbeil,   134,   150 
Giotto,  211,   306 
Giovanni    of    Arcoli,    313,    324, 

328 
Glands,  cervical,  259 
Goitre,  33,  151;   cystic,  259 
Gold  reserve,  316 
Gordon,  Bernard,  276,  286 
Graduate,  208 
Graecisms,  237 
Granada,  75 
Gratz  College,  75 
Gravity,  specific,  342 
Greeks,    From   the,   to    Darwin, 

406 
Gregory   IX,    83;    of   Nazianzen, 

24 
Gruel,   131 
Guadalquivir,    93 
Guerini,   315 
Guimarus   II,    143 
Guiscard,  145 
Gurlt,  29,  48,  109,  139,  156,  219, 

236,   239,   244,   248,   259,   312, 

329,    331 
Guy  de  Chauliac,    16,   208,   229, 

270,  275,  232,  422 


INDEX 


441 


H 


Haeser,  61 

Haliography,    376 

Hallam,  85 

Hamilton,     Sir  Wm.,  407 

Harnack,  25,   26,   382,  392 

Haroun  al-Raschid,   74 

Harvey,  166,  209,   355 

Harun  al-Raschid,  56,   112 

Headache,   42 

Hegel,   407 

Eegira,  170 

Hegius,   345,   361 

Heidelberg,  345 

Helena,  24 

Heloise,    189 

Hemicrania,   42 

Hemoptyses,  45 

Heraclius,  54 

Hermondaville,   264 

Hernia,  298;  radical  cure  of,  299 

Herophilus,  221,  384 

Hierakas,  26 

Hildegarde,    190 

Hippocrates,  13,  91,  99,  117,  266, 
385,   429 

"  Histoire  des  Femmes  Mgdecins," 
195 

Historia  Tripartita,  429 

History  of  the  Inductive  Sci- 
ences,  410 

Hobart,  393 

Hobeisch,  58 

Hollanduses,    358 

Homer,  375,  391 

Honein  Ben  Ischak,  57 

Honein  Ben  Ishac,    117 

Honey,  103 

Horse   Lucanee,    390 

Horace,  267 

Hortus  Deliciarum,  191 

Hospitals,    8 

Hospitals  for  children,  25 

Hroswitha,   190 

Hugh   of   Lucca,   257 

Hugo  of  Lucca,  245,  267,  273 

Humboldt,   412 

Huxley,  150,  307,  412 

Hydrocephalus,   257 

Hydropikos,    385 

Hydrophobia,  435 

Hysteria,  54 


Ibn    Sina,    128 

Ibn   Zeinel-Taberi,    115 

Ibn-Zohr,  130 

Ignorance,      on      learned,      340; 

grounds  of,  409 
Ignorantia,  De  Docta,  339 
Iliac  passion,  279 
Iliad,  375 
Illustrations,    230;    dental,   331; 

first  medical,  275 
Incunabula,  311,  329 
Infection,   241 
Innocent  III,  83;  IV,  83 
Insanity,  434 
Inspection,   47 

Invasion  of  the  barbarians,  26 
Isaac  Ben  Amram,  76 
Isaac  Ben  Emram,  73 
Isaac  Ben   Soliman,  76 
Isaac  Judams,   170,   173 
Isagoge,   58 
Ishac  Ben  Honein,  58 
Isidore  of  Seville,  St.,   113,  431 
Israels,  A.  H.,  66 
Israeli,  76 


Jacobus  de  Forlivio,  130 

Jacobus  de  Partibus,  130 

Jewish  physicians,  7 

Johannes  Afflacius,   171 

Johannesbrod,  102 

Johannitius,  57 

John  Chrysostom,  St.,  11,  181 

John  de  Vigo,  209 

John  Masuee,   74 

John  of  Arcoli,  18,  209 

John  of  Gaddesden,  286 

Josephus,  29 

Joshua  Ben  Nun,  74 

Jude   Sabatai,   78 

Julian  the  Apostate,  8,  23 

Justinian,    26,   28 


K 


Kant,  407 
Kerckringius,   366 
Kircher,  366 


442 


OLD-TIME  MAKERS  OF  MEDICINE 


Koran,  106,  139 
Kostaben  Luka,  58 
Kuhns,  418 


Lactantius,    27 

Lancisi,    209 

Landau,  67 

Lane  Lectures,  354 

Lanfranc,  16,  209,  245,  260,  267 

Laurentian  Library,  180 

Lead  pipe,  239 

Leo,   55 

Leonardo  da  Vinci,  360 

Leonides,   36 

Leoparda,   181 

Lewes,  406 

Libraries,  6 

Life,   intellectual,    5 

Ligatures,      155;      around      the 

limbs,  54 
Lilium  Medicinse,  158 
Linacre,    209,    360 
Lipinska,  Dr.  Melanie,  195 
Livy,  4 
Lopez,  82 
Love,   373 

Lowell,   Russell,   371 
Lucan,   4,   94,   113 
Lucca,  248 
Lucretius,   395 
Ludwig's   angina,   332 
Luke,    St.,    7;    the   physican,    8; 

supposed  inaccuracies,   397 
Lupus,  256 


M 


Machine,  Flying,  416 

Madness,  434 

Magna  Gra^cia,    15,   156,    177 

Magnet,  269 

Magnetism,  404 

Mahmoud,   75 

Maimonides,    12,    88,    90;    rules 

of  life,  100 
Malcorona,   182 
Malgaigne,   118,   303,  306 
Malpighi,   209 
Malta,  97 
Man,  95 


Mandeville,  264 

Mania,   44 

Manipulation,   surgical,   250 

Mantua,  4 

Marsupium  cordis,    15 

Martial,  4,  113,  181 

Maser  Djawah,   72 

Matter  and   form,   351,  417 

Matter,  indestructibility  of,  416 

Matthseus  de  Gradibus,  130 

Matthew  Platearius,  134 

Mediastinum,    137 

Medioa,   181 

Medical,    first    illustrations,    275 

Medicine,  legal,  252;   New  York 

Academy  of,  223 
Melancholia,    44 
Mengenberger,   276 
Meningitis,  43 
Mental  influence,  44 
"Merchant  of   Venice,   The,"   82 
Mercuriade,    186 
Mesmer,  105 
Meteors,  414 
Metrodora,  180 
Metrorrhagia,  54 
Meyer,   413 
Michael  Angelo,   360 
Michael   Scot,    134 
Microtechnics,   171 
Middle  meningeal  artery,   37 
Middleton,   246 
Migne,   194 
Milan,   206 

Milk,  bath,  131;  cure,  45 
Milman,  84 

Ministry  of  Christ,  390 
Miscellany,   124 
Modena,  248 
Mohammed,  13 
Monasteries,  6 
Mondeville,    207,    209,    231,    264, 

298,  422 
Mondino,  202,   209,   245;    career, 

232;   myth,  216 
Monks'  bane,   364 
Montaigne,  374 
Monte  Cassino,  12,  145,  163,  168, 

433 
Montpellier,  11,  16,  87,  265 
Morgagni,   91,  209 
Moses,    64 
Mosei  Ben  Maimum,  91 


INDEX 


443 


N 


Nain,  widow  of,  389 

Naples,  248 

Nature,  47,   77,   378;    in  Dante, 

418 
Neander,  84 
Needleholder,   295 
Nemesius,  9 
Nerve  suture,  253,  262 
Nestorian,  73,   109 
Newton,  351,  355 
Nibelungen,  218 
Nibelungenlied,   375,  392 
Nicaise,  198,  208,  265,  286,  292, 

302,  309 
Nicer  ata,  181 

Nicholas  of  Cusa,  19,  337,  344 
Nicolaus,  Leonicenus,  130 
Nobel  Prize,  421 
Noli  me  tangere,  256 
Nosology,  159 
Notker  Teutonicus,  428 
Novelties,  medical,  166 
Nuremberg   eggs,    337 
Nursing,  271;   history  of,  401 
Nutrition  per  rectum,  130 
Nutting,  401 


0 

Observations,   282,  293,   378 
Octavius  Horatianus,   180 
Odyssey,   375 
Oil  and  wine,  387 
Old  Testament,   63 
Omar,    110 
Omentum,  250 
Operation  for  hernia,  52 
Ophthalmology,   258 
Opotherapy,    68 
Oppler,    100 
Opus  Majus,  409 
Opus  Tertium,  409 
Ordericus  Vi talis,   182 
Organization   of    medical    educa- 
tion, 141 
Oribasius,    8,    38,    117 
Origenia,   180 
Orthodontia,  318 
Osborn,  406 
Osier,   257 


Ossian,   375 
Ovid,    267 
Oxygen,  49 


Padua,  4,  16,  232,  248,  328,  345 
Pagel,    61,    111,    119,    152,    156, 

157,    172,    208,    216,   245,   264, 

277,  286,   230 
Palmyra,    109 
Palpation,   47 

Pandects,  38;   of  Haroun,  72 
Paracelsus,  2,   254,  379 
Paracentesis,    122,    365 
Paradiso,   215 
Pare,  Ambroise,   254,   303 
Paris,    141 
Paris,  Paulin,  310 
Passavant,  Jean  de,  260 
Passow,   386 
Pasquier,  200 
Paul  of  Mgina,  10,  50,  117,  122, 

125,   317,    331 
Paulus  ^Eginetus,  29,  38 
Pavia,  248 
Percussion,   19 
Peregrinus,  404 
Pergamos,   135,   385 
Perineum,  torn,   184 
Persecutions,     Christian,     4;     of 

Jews,  83 
Persius,   4 
Perugia,   248 
Perugino,  360 
Peter  of  Spain,  300 
Petrarch,   306 
Petrus  de  Argentaria,  290 
Phagedenic  ulcer,  35 
Pharmacy,    207 
Pharmacologist,  354 
Phenicia,  314 
Philip    Augustus,    150 
Philosopher's  stone,  369,  412 
Philosopher's  keys,   376 
Phrenitis,  43 

Physicians  and   surgery,   267 
Physiology,  history  of,   354,  414 
Piacenza,    16,   232,   248 
Pilcher,     Dr.    Lewis,     215,    216, 

219,  229 
Pinturicchio,  360 
Pisa,    16,   248 


444 


OLD-TIME  MAKERS  OF  MEDICINE 


Pitard,  Jean,   265,  269 

Plagiarism,  medieval,  174 

Plague,   305 

Platearius  I,  183 

Plato,  267,  292 

Pleurisy,  45 

Pliny,   4,    113 

Polyps,  31,  118,  258,  330;  nasal, 
126,  258 

Pool,  93 

Pope  Boniface  VIII,  288 

Pope    Clement  VI,   300 

Pope  Innocent  VI,  300 

Pope  John  XXI,  300,  357 

Pope  Urban  V,  300 

Popes  and  Jews,  80;  and  sci- 
ence,  148 

Popular  Science  Monthly,  400 

Porphyry,   428 

Portal,   304 

Portio  vaginalis  hypertrophy,  37 

Pouchet,   431 

Practice,  medical,   15 

Preface,  230 

Priscian,    180 

Probe,  280 

Professional  spirit,   141 

Professione  Medicorum,    181 

Prohibition  of  chemistry,  424 

Prophylaxis,    47;    perineal,    185 

Prudentius,  113 

Pseudo-philology,    364 

Psycho-analysis,    68 

Ptolemy,  73,  384 

"Puch  der  Natur,"  275 

Pulse,  19,   160 

Pure  Drug  Law,  420 

Puschmann,  41,  61,  144,  150 

Pus,    unnecessary,    255 


Q 


Quackery,  273 
Quacks,  371 
Quadrivium,    149 
Quintilian,   4,   113 


Rab,  69 

Rabbi  Ishmael,  66 
Rabies,    30;    diagnosis    of,    263, 
435;  treatment,  262 


Radio-active   elements,   350 

Radio-activity,    399 

Radium,  350 

Ragenifrid,   144 

Ramsay,   Sir   William,   394,  417 

Raphael,   360 

Rebecca  Guarna,  186 

Reggio,  248 

Regimen  Sanitatis,   158 

Regiomontanus,  360 

Religion  of  healing,  25 

Religious    scruples,    224 

Renaissance,  20,  142 

Renan,    132,   314 

Respiration  rate,  342 

Reuchlin,    361 

Reynaud,  M.  Jean,  375 

Rhazes,    59,    114,    170,   266,   323, 

331;    aphorisms,    116 
Richard  Coeur  de  Lion,  98 
Richard  the  Englishman,  276 
Rima  glottidis,  23 
Robinson,  Dr.  Nathaniel,  390 
Rodent  ulcer,  35 
Rogero,  237 
Roland,    273 
Rolando,   154,   238,  242 
Romanes,   405 

Roman    Empire   decadent,    5 
Roman  patronage,  2 
Roman   persecutions,   26 
Rome,   248 
Romoaldus,   134 
Rosa  Anglice,  287 
Roth,   288 
Rudolph,   82 
Ruggero,   237 
Ruggiero,   146 
Rules   of   life,    100 
Rupertsberg,  192 
Rutebeuf,   183 


S 

St.  Benedict,   191 

St.  Brigid,  179 

St.  Dominic,  215 

St.  Gall,  433 

St.   Luke,   381,   382 

St.  Patrick,  179 

St.  Peter's  Epistle,  398 

St.  Thomas  of  Aquin,  352 


INDEX 


445 


Saintsbury,  402 

Sacrament,   164 

Saladin,  90 

Salerno,    11,    13,    78,    141,    236, 

273 
Salieet,  209,  247 
Salvation,    25 
Samarcand,  111 
Sanctions  of  belief,   105 
Sanitary  science,  64 
Santa  Sophia,   10,  40 
Saracenus,    171 
Saragossa,   75 
Scholarship,    136 
Scholastica,   178,   191 
Science,  biological,  413;   popular 

medieval,  425;   medieval,  400 
Scientia  Experimentalis,   410 
Scotus,  134 

Scribonius  Largus,   180 
Scrobiculus  cordis,   137 
Sea  sponge,  151 
Semiotics,    159 
Seneca,  4,  94,   113,  267 
Serapion,    170 
Servetus,  2 
Seville,  75 
Shakespeare,  82 
Shawdepisse,   280 
Shower  bath,   172 
Sidon,  314 
Sienna,  248 
Sighart,   413 
Signorelli,    360 
Silver  Age,   13,   113 
Sintheim,    344 
Small-pox,   119 
Snake    bites,    263 
Snare,   126 
Socrates,  292,  429 
Solomon,  98 
Sozomen,    429 
Spagyrist,    369 
Spallanzani,   209 
Spanish  peninsula,  4 
Speculum,  331 
Bphudron,   386 
Sprengel,    77 
Standards  of  medical  education, 

420 
Static   experiments,   340 
Steno,   366 
Studia  generalia,  203 


Studies,   post-graduate,   283 

Superstitions,    21 

Surgeon,  as  teacher,  261;  qual- 
ities of,  261,  305;  good,  268; 
perfect,   268;    training  of,   267 

Surgery,  aseptic,  245;  antisep- 
tic, 255;  dishonor  of,  424; 
epoch  of,  281;  Genito-urinary, 
126,  234;  history  of,  273; 
of  the  mind,  270;  quality  of, 
305;  union  in,  249,  260 

Surgical,  meddlesomeness,  300 ; 
nursing,  271 

Sydenham,   91 

Sylvester  II,  134 

Sylvius,  2 

Symmachus,  428 

Synanche,  332 


T 

Taddeo  Alderotti,  212,  215,  232 

Talmud,   11,  63,  65,   94 

Tarsus,  135 

Tartar,  321 

Tattooing,  31 

Taxes,  298 

Technique,    Surgical,    125 

Teleology,    27,    95 

Tell's   apple,    364 

Tenaculum,  258,   330 

Terence,  4,  190 

Tertullian,  27 

Testament,  Old,  11 

Thaddseus    Florentinus,    130 

Thecla,    180 

Theodoret,  27 

Theodoric,  245,  252,  267,  273, 
429 

Theodosia,   10,   181 

Theodotos,   26 

"Theology  and  Science,"  419 

Theophilus,  54,  55 

"Thirteenth  Greatest  of  Centu- 
ries,"  433 

Thomas  Cantimprato,  433 

Thompson,  358 

Thorax,  295 

Thymol,  50 

Titian,  360 

Toledo,  75,  170 

Tonnerre  Hospital,  296 


446 


OLD-TIME  MAKERS  OF  MEDICINE 


Tonsils,   29 

Tooth  powder,  321;   replacement 

of,  322 
Tornamira,   312 
Toscanelli,  360 
Toulouse,   286 
Tours,  433 


U 


Ugo  da  Lucca,  251,  295 

Ugo   Senesis,    130 

Ulcer,  eroding,  256 

Union  by  first  intention,  254 

Universitas,  203 

Universities,    ecclesiastical,    210; 

medieval,    411 
University   of    Bologna,    142;    of 

Paris,      887,      142,      199;      of 

Salerno,   142 
University  man,  typical,   307 
Urine,  19 

Urination,    difficulty   of,    334 
Uvula,    118,    259,    332;    removal 

of,  333 


Valentine,  20,  349;  bibliogra- 
phy,  376 

Vale  sco  de  Taranta,  312 

Van  Helmont,  365 

Varices,  34 

Varicose  veins,  127 

Varignana,   130 

Varolius,    2,   209,   327 

Vasari,    360 

Velum  Palati,   137 

Venerable  Bede,  432 

Venesection,    104 

Vercelli,   248 

Verneuil,   303 

Verney,    Francis,    311 

Verona,  248 

Vesalius,  2,  120,  204,  209,  233, 
289,    327 

Vicenza,   16,  232,  248 

Victoria,    180 

Vigo,  John  De,  334 


Villani,  313 

Vincent  of  Beauvais,  433 

Virchow,   297 

Virgil,  4 

Vitality,  natural,   116 

Volta,  209 

Von  Leyden,   336 

W 

"  Warfare  of  Science  and  Reli- 
gion," 434 

Washington's   hatchet,   364 

Water  clock,  341 

Water  in  the  ear,  48 

Watering  places,  47 

Wenceslaus,   Emperor,   424 

Whewell,   410 

White,    Pres.,    424 

Wine   for  wounds,    187 

William  of   Auvergne,    108 

William  of  Briscia,  268 

William  of  Salice.t,  245,  256, 
267 

William  the  Conqueror,  145 

Wimpheling,   361 

Wives   as   nurses,   272 

Women  professors,   15 

Women  physicians,   177,    179 

Wood  hound,  435 

Wounds,  penetrating,  250;  ad- 
hesion, 253;  gunshot,  334;  of 
intestines,  250;  wine  and  oil, 
387 

Wurtz,  254 


Yahia  Ben  Masoviah,  74 
Yard,  280 
Yperman,   276 
Ypres,  276 


Zedkias,   78 
Zenobia,    109 
Zoology,   418 


Other  Books  by  Dr.  Walsh 


FORDHAM  UNIVERSITY  PRESS  SERIES 

MAKERS  OP  MODERN  MEDICINE— A  series  of  Biogra- 
phies of  the  men  to  whom  -we  owe  the  important  advances  in 
the  development  of  modern  medicine.  By  James  J.  Walsh, 
M.  D.,  Ph.  D.,  LL.  D.,  Dean  and  Professor  of  the  History  of  Medi- 
cine at  Fordham  University  School  of  Medicine,  N.  Y.  Second 
Edition,  1909.     362  pp.     Price,  $2.00  net. 

The  London  Lancet  said :  "  The  list  is  well  chosen,  and  we  have  to 
express  gratitude  for  so  convenient  and  agreeable  a  collection  of 
biographies,  for  which  we  might  otherwise  have  to  search  through 
many  scattered  books.  The  sketches  are  pleasantly  written,  inter- 
esting, and  well  adapted  to  convey  the  thoughtful  members  of  our 
profession  just  the  amount  of  historical  knowledge  that  they  would 
wish  to  obtain.    We  hope  that  the  book  will  find  many  readers." 

The  New  York  Times:  "The  book  is  intended  primarily  for  stu- 
dents of  medicine,  but  laymen  will  find  it  not  a  little  interesting." 

77  Morgagni  (Italy)  :  "  Professor  Walsh  narrates  important  lives 
in  modern  medicine  with  an  easy  style  that  makes  his  book  delight- 
ful reading.  It  certainly  will  give  the  young  physician  an  excellent 
idea  of  who  made  our  modern  medicine." 

The  Lamp :  "  This  exceptionally  interesting  book  is  from  the  prac- 
ticed hand  of  Dr.  James  J.  Walsh.  It  is  a  suggestive  thought  that 
all  of  the  great  specialists  portrayed  were  God-fearing  men,  men 
of  faith,  far  removed  from  the  shallow  materialism  that  frequently 
flaunts  itself  as  inherently  worthy  of  extra  consideration  for  its 
own  sake." 

The  Church  Standard  {Protestant  Episcopal)  :  "  There  is  perhaps 
no  profession  in  which  the  lives  of  its  leaders  would  make  more 
fascinating  reading  than  that  of  medicine,  and  Dr.  Walsh  by  his 
clever  style  and  sympathetic  treatment  by  no  means  mars  the  interest 
which  we  might  thus  expect." 

The  New  York  Medical  Journal:  "  We  welcome  works  of  this 
kind ;  they  are  evidence  of  the  growth  of  culture  within  the  medical 
profession,  which  betokens  that  the  time  has  come  when  our  teachers 
have  the  leisure  to  look  backward  to  what  has  been  accomplished." 

Science:  "The  sketches  are  extremely  entertaining  and  useful. 
Perhaps  the  most  striking  thing  is  that  every  one  of  the  men  de- 
scribed was  of  the  Catholic  faith,  and  the  dominant  idea  is  that  great 
scientific  work  is  not  incompatible  with  devout  adherence  to  the 
tenets  of  the  Catholic  religion." 


THE  POPES  AND  SCIENCE— The  story  of  the  Papal  Rela- 
tions to  Science  from  the  Middle  Ages  down  to  the  Nineteenth 
Century.  By  James  J.  Walsh,  M.  D.,  Ph.  D.,  LL.  D.  440  pp. 
Price,  $2.00  net. 

Prof.  Pagel,  Professor  of  History  at  the  University  of  Berlin: 
"This  book  represents  the  most  serious  contribution  to  the  history 
of  medicine  that  has  ever  come  out  of  America." 

Sir  Clifford  Allbutt,  Regius  Professor  of  Physic  at  the  Uni- 
versity of  Cambridge  (England)  :  "The  book  as  a  whole  is  a  fair 
as  well  as  a  scholarly  argument." 

The  Evening  Post  (New  York)  says:  "However  strong  the 
reader's  prejudice  *  *  *  *  he  cannot  lay  down  Prof.  Walsh's  volume 
without  at  least  conceding  that  the  author  has  driven  his  pen  hard 
and  deep  into  the  '  academic  superstition  '  about  Papal  Opposition  to 
science."  In  a  previous  issue  it  had  said :  "  We  venture  to  prophesy 
that  all  who  swear  by  Dr.  Andrew  D.  White's  History  of  the  War- 
fare of  Science  with  Theology  in  Christendom  will  find  their  hands 
full,  if  they  attempt  to  answer  Dr.  James  J.  Walsh's  The  Popes 
and  Science." 

The  Literary  Digest  said:  "The  book  is  well  worth  reading  for 
its  extensive  learning  and  the  vigor  of  its  style." 

The  Southern  Messenger  says :  "  Books  like  this  make  it  clear 
that  it  is  ignorance  alone  that  makes  people,  even  supposedly  edu- 
cated people,  still  cling  to  the  old  calumnies." 

The  Nation  (New  York)  says:  "The  learned  Fordham  Physician 
has  at  command  an  enormous  mass  of  facts,  and  he  orders  them 
with  logic,  force  and  literary  ease.  Prof.  Walsh  convicts  his  oppo- 
nents of  hasty  generalizing  if  not  anti-clerical  zeal." 

The  Pittsburg  Post  says :  "  With  the  fair  attitude  of  mind  and  in- 
fluenced only  by  the  student's  desire  to  procure  knowledge,  this 
book  becomes  at  once  something  to  fascinate.  On  every  page 
authoritative  facts  confute  the  stereotyped  statement  of  the  purely 
theological  publications." 

Prof.  Welch,  of  Johns  Hopkins,  quoting  Martial,  said :  "  It  is 
pleasant  indeed  to  drink  at  the  living  fountain-heads  of  knowledge 
after  previously  having  had  only  the  stagnant  pools  of  second-hand 
authority." 

Prof.  Piersol,  Professor  of  Anatomy  at  the  University  of  Penn- 
sylvania, said :  "  I  have  been  reading  the  book  with  the  keenest 
interest,  for  it  indeed  presents  many  subjects  in  what  to  me  at  least 
is  a  new  light.  Every  man  of  science  looks  to  the  beacon — truth — 
as  his  guiding  mark,  and  every  opportunity  to  replace  even  time- 
honored  misconceptions  by  what  is  really  the  truth  must  be  wel- 
comed." 

The  Independent  (New  York)  said:  "Dr.  Walsh's  books  should 
be  read  in  connection  with  attacks  upon  the  Popes  in  the  matter  of 
science  by  those  who  want  to  get  both  sides." 


MAKERS  OF  ELECTRICITY  —  By  Brother  Potamian, 
F.  C.  SM  Sc.  D.  (London),  Professor  of  Physics  in  Manhattan 
College,  and  James  J.  Walsh,  M.  D.,  Ph.  D.,  Litt.  D.,  Dean  and 
Professor  of  the  History  of  Medicine  and  of  Nervous  Diseases 
at  Fordham  University  School  of  Medicine,  New  York.  Ford- 
ham  University  Press,  110  West  74th  Street.  Illustrated. 
Price,  $2.00  net.    Postage,  15  cents  extra. 

The  Scientific  American:  "One  will  find  in  this  book  very  good 
sketches  of  the  lives  of  the  great  pioneers  in  Electricity,  with  a 
clear  presentation  of  how  it  was  that  these  men  came  to  make  their 
fundamental  experiments,  and  how  we  now  reach  conclusions  in 
Science  that  would  have  been  impossible  until  their  work  of  reveal- 
ing was  done.  The  biographies  are  those  of  Peregrinus,  Columbus, 
Norman  and  Gilbert,  Franklin  and  some  contemporaries,  Galvini, 
Volta,  Coulomb,  Oersted,  Ampere,  Ohm,  Faraday,  Clerk  Maxwell,. 
and  Kelvin." 

The  Boston  Globe:  "The  book  is  of  surpassing  interest." 

The  New  York  Sun:  "The  researches  of  Brother  Potamian 
among  the  pioneers  in  antiquity  and  the  Middle  Ages  are  perhaps 
more  interesting  than  Dr.  Walsh's  admirable  summaries  of  the 
accomplishment  of  the  heroes  of  modern  science.  The  book  tes- 
tifies to  the  excellence  of  Catholic  scholarship." 

The  Evening  Post:  "It  is  a  matter  of  importance  that  the  work 
and  lives  of  men  like  Gilbert,  Franklin,  Galvini,  Volta,  Ampere  and 
others  should  be  made  known  to  the  students  of  Electricity,  and  this 
office  has  been  well  fulfilled  by  the  present  authors.  The  book  is  no 
mere  compilation,  but  brings  out  many  interesting  and  obscure  facts, 
especially  about  the  earlier  men." 

The  Philadelphia  Record:  "It  is  a  glance  at  the  whole  field  of 
Electricity  by  men  who  are  noted  for  the  thoroughness  of  their  re- 
search, and  it  should  be  made  accessible  to  every  reader  capable  of 
taking  a  serious  interest  in  the  wonderful  phenomena  of  nature." 

Electrical  World:  "Aside  from  the  intrinsic  interest  of  its  mat- 
ter, the  book  is  delightful  to  read  owing  to  the  graceful  literary 
style  common  to  both  authors.  One  not  having  the  slightest  ac- 
quaintance with  electrical  science  will  find  the  book  of  absorbing 
interest  as  treating  in  a  human  way  and  with  literary  art  the  life 
work  of  some  of  the  greatest  men  of  modern  times;  and,  moreover, 
in  the  course  of  his  reading  he  will  incidentally  obtain  a  sound 
knowledge  of  the  main  principles  upon  which  almost  all  present- 
day  electrical  development  is  based.  It  is  a  shining  example  of  how 
science  can  be  popularized  without  the  slightest  twisting  of  facts  or 
distortion  of  perspective.  Electrical  readers  will  find  the  book  also 
a  scholarly  treatise  on  the  evolution  of  electrical  science,  and  a 
most  refreshing  change  from  the  'engineering  English'  of  the 
typical  technical  writer." 


EDUCATION,  HOW  OLD  THE  NEW  — A  Series  of  Lee- 
tures  and  Addresses  on  Phases  of  Education  in  the  Past 
Which  Anticipate  Most  of  Our  Modern  Advances,  by  James 
J.  Walsh,  M.D.,  Ph.D.,  Litt.  D.,  K.  C.  St.  G.,  Dean  and  Pro- 
fessor of  the  History  of  Medicine  and  of  Nervous  Diseases  at 
Fordham  University  School  of  Medicine.  Fordham  University 
Press,  1910.  470  pp.  Price,  $2.00  net.  Postage,  15  cents 
extra. 

Cardinal  Moran  (Sydney,  Australia)  :  "I  have  to  thank  you  for 
the  excellent  volume  '  Education,  How  Old  the  New.'  The  lectures 
are  admirable,  just  the  sort  of  reading  we  want  for  English  read- 
ers of  the  present  day." 

New  York  Sun:  "  It  is  all  bright  and  witty  and  based  on  deep 
erudition." 

The  North  American  (Philadelphia):  "Wide  historical  research, 
clear  graphic  statement  are  salient  elements  of  this  interesting  and 
suggestive  addition  to  the  modern  welter  of  educational  literature." 

Detroit  Free  Press:  "  Full  of  interesting  facts  and  parallels  drawn 
from  them  that  afford  much  material  for  reflection." 

Chicago  Inter-Ocean:  "  Incidentally  it  does  away  with  a  num- 
ber of  popular  misconceptions  as  to  education  in  the  Middle  Ages 
and  as  to  education  in  the  Latin- American  countries  at  a  somewhat 
later  time.  The  book  is  written  in  a  straight,  unpretentious  ani  in- 
teresting style." 

Wilkes-Barre  Record:  "The  volume  is  most  interesting  and 
shows  deep  research  bearing  the  marks  of  the  indefatigable  student." 

Pittsburg  Post:  "There  is  no  bitterness  of  controversy  and  one 
of  the  first  things  to  strike  the  reader  is  that  the  dean  of  Fordham 
quotes  from  nearly  everybody  worth  while,  Protestant  or  Catholic, 
poetry,  biography,  history,  science  or  what  not." 

The  Wall  Street  News  (New  York)  :  "The  book  is  calculated  to 
cause  a  healthy  reduction  in  the  conceit  which  each  generation  en- 
joys at  the  expense  of  that  which  preceded  it." 

Rochester  Post  Express:  "The  book  is  well  worth  reading." 

The  New  Orleans  Democrat:  "The  book  makes  very  interesting 
reading,  but  there  is  a  succession  of  shocks  in  store  in  it  for  the 
complacent  New  Englander  or  Bostonian  and  for  the  orthodox  or 
perfunctory  reader  of  American  literature." 


CATHOLIC  SUMMER  SCHOOL  PRESS  SERIES 

The  highest  value  attaches  to  historical  research  on  the  lines  you 
so  ably  indicate,  especially  at  the  present  time,  when  the  enemies  of 
Holy  Church  are  making  renewed  efforts  to  show  her  antagonism  to 
science  and  human  progress  generally.  I  shall  have  much  pleasure 
in  perusing  your  work  entitled  "  The  Thirteenth  Greatest  of  Cen- 
turies." 

Wishing  you  every  blessing,  I  am,  Yours  sincerely  in  Xt, 

R.  Card.  Merry  Del  Val. 
Rome,  January  18th,  1908. 

Jas.  J.  Walsh,  Esq.,  New  York. 

THE  THIRTEENTH  GREATEST  OF  CENTURIES— By 
James  J.  Walsh,  M.  D.,  Ph.  D.,  Litt.  D.,  Dean  and  Professor  of 
Nervous  Diseases  and  of  the  History  of  Medicine  at  Fordham 
University  School  of  Medicine;  Professor  of  Physiological 
Psychology  at  Cathedral  College,  New  York.  Catholic  Sum- 
mer School  Press,  110  West  74th  Street,  N.  Y.,  Georgetown 
University  Edition.  Over  100  additional  illustrations  and 
twenty-six  chapters  that  might  have  been,  nearly  600  pages. 
Price,  $3.50,  post  free. 

Prof.  William  Osler,  of  Oxford,  delivering  the  Linacre  Lecture 
before  the  University  of  Cambridge,  said :  "  That  good  son  of  the 
Church  and  of  the  profession,  Dr.  James  J.  Walsh,  has  recently 
published  a  charming  book  on  The  Thirteenth  as  the  Greatest  of 
Centuries.  He  makes  a  very  good  case  for  what  is  called  the  First 
Renaissance." 

The  Saturday  Review  (of  London):  "The  volume  contains  a 
mass  of  interesting  facts  that  will  start  a  train  of  profitable 
thought  in  many  readers'  minds." 

The  Educational  Review  said:  "The  title  of  Dr.  Walsh's  book, 
The  Thirteenth  Greatest  of  Centuries,  will  startle  many  readers,  but 
we  respectfully  commend  to  the  open-minded  his  presentation  of 
that  great  epoch.  A  century  that  witnessed  such  extraordinary 
achievements  in  architecture,  in  arts  and  crafts,  in  education,  and  in 
literature  and  law,  as  did  the  Thirteenth,  is  not  to  be  lightly  dis- 
missed or  unfavorably  compared  with  periods  nearer  our  own." 

The  Pittsburg  Post  said:  "Dr.  Walsh  writes  infused  with  all  the 
learning  of  the  past,  enthusiastic  in  modern  research,  and  sympa- 
thetic, in  true  scholarly  style,  with  investigation  in  every  line.  One 
need  only  run  over  a  few  of  the  topical  headings  to  feel  how 
plausible  the  thesis  is.  The  assemblage  of  the  facts  and  the  elucida- 
tion of  their  mutual  relations  by  Dr.  Walsh  shows  the  master's 
skill.  The  work  bristles  on  every  page  with  facts  that  may  be 
familiar  to  many,  but  which  were  never  before  so  arranged  in  just 
perspective  with  their  convincing  force  so  clearly  shown." 

Cardinal  Moran.  of  Sydney,  Australia:  "Just  the  sort  of  litera- 
ture We  want  for  English  readers  at  the  present  day." 


7986    016 


DATEDUE 


UNIVERSITY 


PR05UCTS^NC^859-5503 


*  wc. 


Nw     9.1    1985 


100 i  [£j 

CHARLt 


BOSTON  COLLEGE 


3  9031   01534115  9 


